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RangerZ
03-22-2013, 21:34
I want to start a thread about the logistics of thru hiking with diabetes. I'm looking for some wisdom about maildrops, etc - I think nutrition is being well covered in other threads.

I am thinking about / starting to plan a 2015 (or later) thru hike.

My thoughts run like this, the insulin pens set the resupply interval. I go thru a fast acting pen in about 16 days and a long acting pen in about 11 days. The common denominator of those two numbers is about 32 days (2 fast acting pens and 3 long acting), with a factor of safety say a resupply after 24 days.

I get 25 test strips in a vial, but 100 would fit, at 4 per day that's 25 days.

The plastic containers that I use for sharps last me about 27 days, one to contain new needles and lancets, and another for used.

Alcohol pads are easy.

For planning purposes use map man's section hiking rates to template out where you might be every 24 days or so and plan a drop box at an appropriate place - avoid the PO that may be closed, etc - use Baltimore Jack's resupply information.

Yes, you could carry twice as much and resupply half as often. Yes, you might test more often, test strips are light, carry more. Yes, you might use less insulin, be flexible and extend the resupply interval.

The drop box would have insulin pens, alcohol pads, needles and Lancets (in a sharps container) - and other stuff, like food.


BD Diabetes Products has sharps disposal guidelines by state - http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=10284 . In general, opaque, hard shelled, labeled and taped - every state is a little different.


Am I overthinking this or what? What has worked for people?

Busky2
03-23-2013, 09:36
No way are you over thinking! DO you carry a MEDIC ALERT BRACELET so if some does come upon you in trouble they know whats going on? I also wonder about Glucose concentrate for a unscheduled low? My issues would tend to be of the LBS level dangers. Sounds like you have a good bit of careful thought already under your hat, good for you and good luck.

Jack Tarlin
03-23-2013, 10:57
My good friend Brendan Fitzpatrick "The Dude" has hiked thousands miles on the A.T. with diabetes. You can easily find him on Facebook and I'm sure he'd be a good resource for you.

Options
03-23-2013, 12:58
RangerZ, I am IDDM and planning a thru-hike for 2014. I'm working on logistics now and supplies and dependable drops are at the top my list. I currently use a pump but I am thinking of returning to injections for the thru.

RangerZ
03-23-2013, 18:52
I wear a red diabetes dog tag and carry glucose and a card. I have had good control and haven't experienced a low. My local hikes, not as strenous as the AT, haven't given me any problems. I may do a week on the AT here in PA this summer as a test run.

The threads about nutrition and changing insulin rates are interesting, I'm not just there yet. Got to talk to the doc and nutritionist.

Driver8
03-23-2013, 20:34
Thanks for starting this thread, Ranger, and to others for contributing. I am diabetic, have lived with it over a decade, more recently have needed the Lantis. I am interested to know more about how to manage this out hiking, starting with day and section hikes.

One question: to what degree is temperature of the pens a worry? Lantis recommends refrigerating its pens until they're used - following this, the only one not in my fridge is the one in use on the bathroom counter. Do pens on the trail in warmer weather need to be kept in a cooling apparatus? If so, what do you recommend?

RangerZ
03-23-2013, 23:39
I'm the wrong person to ask that, I don't have the on trail experience. Others on these pages have talked about a water cooler and the evaporative cooling wallets. Within the pack next to a water bottle makes sense also.

Pen Rx info says that unopened pens may also be kept at room temperature for 28 or 42 days depending on the type. It's just that the room we're talking about is 2200 miles long.


I've been dealing with the other end this winter on day hikes. Pens stay warm enough in an insulated case in a day pack.

I get cold exposing my delicate flesh to inject though.


You're not going to carry 6 months worth of pens, that's why I'm interested in the details of diabetic resupply. Get resupplied at the right times, plus have on request boxes planned.

Options
03-24-2013, 10:38
I will use a "Frio" wallet for my insulin storage while on the trail. Also check out Stitch and Figgy's 2007 AT thru at http://www.trailjournals.com/entry.cfm?id=210173. Figgy is insulin dependent and appears to do quite well with her management on long distance hikes.

Driver8
03-24-2013, 11:39
I will use a "Frio" wallet for my insulin storage while on the trail. Also check out Stitch and Figgy's 2007 AT thru at http://www.trailjournals.com/entry.cfm?id=210173. Figgy is insulin dependent and appears to do quite well with her management on long distance hikes.

That's a winner - thanks for the tip, Options. Sounds like a good solution to the problem.

Don H
03-24-2013, 12:56
One word of warning. If you get hooked up with a group don't let them push you so that you skip meals or snacks. This seems obvious but group dynamics can result in poor decisions. I actually saw this happen.

RangerZ
03-24-2013, 19:35
I've just started to template out where I would do diabetic resupply, I'm still in Georgia figuring out daily progress. What's going into your thinking process?

RangerZ
03-24-2013, 19:47
I did a "half marathon", 13.7 miles this afternoon on local trails. I'm virtually hiking the AT, today puts me just short of Hot Springs, NC. Virtual is the way to go, I stay at RangerZ's hostel every night where there are TV, internet, showers, laundry, kitchen privileges, two mousers, and the hostel keeper is friendly.


Work interfers with what I really want to do with my life.

Options
03-25-2013, 21:08
Don H you are so right on the group dynamics. Everyone should hike their own hike. Just like a long run: plan your run and run your plan. Great thread RangerZ, thanks.

RangerZ
03-25-2013, 23:19
I've extracted sharps disposal requirements for the AT states from the BD Diabetes Products link - http://www.bd.com/us/diabetes/page.a...=7002&id=10284 (http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=10284) .

20699

It's everybody's responsibility to act responsible.

RangerZ
03-26-2013, 21:12
I didn't mean to ignore carrying an official sharps container.

I've spent some time tonight checking on pen disposal. I haven't had much success. The states don't seem to mention it, if the manufacturers do its along the lines of "... check with your local regulations ...".

Other threads have also suggested that local hospitals and/or doctors may be willing to dispose of your sharps.

RangerZ
04-10-2013, 22:30
Disclaimers up front: this for general planning purposes for a Type 2 diabetic - hike your own (diabetic) hike. I acknowledge the work done by mapman, Baltimore Jack and others. I’m interested in NOBO, so except for the general presenting of SOBO times, I focused on NOBO. The calendar on the worksheet is for 2013.

I’ve used mapman’s section hiking rates to template where you might be NOBO and SOBO with given starting dates. I worked them out for two week starting intervals. Using average miles per day rather than miles per hiking day includes the zero days that hikers took.

When I started I had no idea of when you would be somewhere, so this at least gave me an idea. This isn’t for detailed planning.

My thought is to plan for a finish date of 15 September at Katahdin (giving a month’s cushion before they close the park); using mapman’s average miles per day requires a start date of 1 April (168 days).

Mapman also gave the time (197 days) that it took 80% of the hikers to finish - by coincidence, for a 1 April start date, the finish date would be 15 October. So, if you’re as fast as 80% of hikers, you should be able to start on 1 April and finish at Katahdin before 15 October. Also by coincidence, it puts you in Damascus for trail days.

Back to the purpose of this thread, when/where do you do diabetic mail drop resupply when thru hiking the AT? It’s easy to figure that you’d need your original supply and five resupplies (168/32), but when/where to resupply?

I added a 32 day interval to the worksheet to show when supplies would run out, then the 24 day resupply interval. Mapman’s miles per day gave the distance along the trail and the location for resupply.

Baltimore Jack’s resupply advice, and the PO and hostel locations available on White Blaze, were all used to select diabetic resupply locations. I haven’t extended this exercise to include other mail drops or food resupply.

The five locations were:

1. Hot Springs, TN – Elmer’s
2. Catawba, VA – 4 Pines Hostel
3. Duncannon, PA – Doyle Hotel
4. Cheshire, MA – Cheshire PO?
5. Rangeley, ME – Maine Roadhouse

Has anyone else gone through this exercise? I’m looking for any practical experience that’s out there. Dependable mail drop locations are important.

These locations are based on using four test strips and pen needles a day, going through a fast acting pen in about 16 days and a long acting pen in about 11 days. If, as others have written, you test more often or use less insulin, the run out times could change. Test more often and you’ll run out before resupply, it’s probably worth it to always carry extra test strips, they’re light and small. Use less insulin and you’ll have some left at resupply times.

Changing the amount of testing and the amount of insulin injected is a topic for another thread.

These are the minimum amounts that I’m proposing for a diabetic resupply drop:

32 lancets (one per day, not one per test)
128 test strips
3 long acting pens
2 fast acting pens
128 pen needles
128 alcohol prep pads

I’d repackage all of the test strips into one or two of the vials that they usually come in. The new lancets and pen needles go in a container, which eventually becomes the next sharps container. Alcohol pads go in a small ziplock.

(I’ve done this for week long business trips and it works for me. I haven’t had any TSA problems yet either).

After you resupply and before you dispose of sharps and empty pens, you might be carrying double the weight. For any light weights out there, this may be about 35 ounces total.

Any medication should probably be carried in the original container. Managing meds is another topic that I’d be interesting in hearing about.

Some items could be “on request” for mail resupply: batteries for the testing device; replacement testing or lancing device; unscheduled resupply of pens, needles, lancets, test strips, alcohol pads.

Since we’re talking about a 6 month thru hike, you’ll probably finish current prescriptions and need them renewed. You’ll be dependent on your support person to do that. Some mail order and retail pharmacies offer automatic prescription renewal now. Your doctor may give you a prescription to use if necessary. Your support person will have to mail the packages on time.

I’d appreciate any experience from people who have thru hiked the AT. Am I completely off base about diabetic mail drop resupply?

I agree that you shouldn’t use hand sanitizer instead of an alcohol wipe, but what about using alcohol fuel?

Sorry about the length of this post.

RangerZ
04-10-2013, 22:38
All that and I forgot the attachment.

Swordpen
04-10-2013, 23:39
I did a "half marathon", 13.7 miles this afternoon on local trails. I'm virtually hiking the AT, today puts me just short of Hot Springs, NC. Virtual is the way to go, I stay at RangerZ's hostel every night where there are TV, internet, showers, laundry, kitchen privileges, two mousers, and the hostel keeper is friendly.


Work interfers with what I really want to do with my life.

do you have a link on the virtual AT trail?

Thanks!

RangerZ
04-11-2013, 07:33
No, I'm just using Google Earth to keep track. I'm up to about 357 miles, between Cherry Gap and Clyde Smith shelters, still in NC. It's hard getting back to RangerZ's hostel every night but last night it was appreciated with thunderstorms here in Pittsburgh.

RangerZ
04-12-2013, 16:01
do you have a link on the virtual AT trail?

Thanks!

I'm waiting for Google Earth to get Street View for the trail.

ColoradoGregg
05-19-2013, 21:48
Interesting thread. The reason I joined white blaze was to be better informed. I have had type 1 diabetes for nearly 30 years. My wife and I have hiked many long ( 8-12 mile ) hikes in the Rockies. We're planning a few 1-2 night hikes this summer. I have an insulin pump that has literally changed my life. Not sure if I'd want to be on the trail more than 2-3 days though.

Options
06-03-2013, 20:44
As I posted earlier I use a pump and plan on a thru-hike in 2014. I agree with you that the pump has changed my life and outlook on living with IDDM. I have had concerns with pump resupply while on the trail and think that MDI's would eliminate a lot of worries with such issues. My doc wants me to reconsider starting a thru with MDI's. He feels I will soon adjust to the resupply logistics. Luckily he has spent some time on the trail and is extremely supportive of the idea of a thru-hike. Currently plan on taking a "pump vacation" this fall with a couple of section hikes to gauge control issues.

Lala1008
10-27-2013, 00:59
I am T1 insulin dependent- the frio is amazing!! Used it on backpacking trips in 100 degree weather in jersey this summer

Lala1008
10-27-2013, 01:07
Hi options! I would love to hear how that goes. I had crazy issues with MDI and very shoddy BG control before I got on the pump. However, I have had some issues hiking with my pump this summer (site coming lose and me not realizing it til the middle of the night, waking with with a 500!!! Happened twice- looked down to find the site all f'n bloody from the knocked against by my pack all day...) however the fact that I can turn basal down to 25% for intense days or up to 75% for easier ones gives me such great control that I'm not sure I'd want to give up when I do my thru hike... Anyway- let me know how your MDI experiment goes!

Robin2013AT
10-27-2013, 05:40
See if you can contact Team Fortis (M80 and Trooper) who thrued this year. M80 is diabetic AND had his service dog with him AND made the summit on 9/18. He is a very helpful (and fun) guy!

squeezebox
10-27-2013, 07:14
Sounds like you got it figured out.
Also think any pharmacy could set you up.
Bryce R.N.

RangerZ
10-28-2013, 17:33
Thanks for rejuvenating this thread. I've advanced on my virtual through hike, I'm at 1025 miles on local trails this year, or at the Ed Garvey shelter on the AT. By coincidence, I was at the Ed Garvey shelter last Monday on a day hike out of Harpers Ferry.

I haven't advance the thru hike planning any. I have evolved in my testing strategy. I test at every hourly break and at the bottom and top of any good climbs, trying to get a handle on what the exertion does to the BGLs. Trail mix or carbs to raise any low BGLs. Like I've said before, I'm a T2 with good control so it's not hard.


I've also startrd to reuse lancets and pen needles all day, changing every morning. It would reduce the resupply amounts. I haven't changed the insulin doses so the basic resupply interval wouldn't change.

RangerZ
10-28-2013, 19:38
Since I don't pump, what are some of the resupply factors? What's the reservoir capacity, etc?

Many Moons
10-28-2013, 23:48
Cut back on your sugar,
I want to start a thread about the logistics of thru hiking with diabetes. I'm looking for some wisdom about maildrops, etc - I think nutrition is being well covered in other threads.

I am thinking about / starting to plan a 2015 (or later) thru hike.

My thoughts run like this, the insulin pens set the resupply interval. I go thru a fast acting pen in about 16 days and a long acting pen in about 11 days. The common denominator of those two numbers is about 32 days (2 fast acting pens and 3 long acting), with a factor of safety say a resupply after 24 days.

I get 25 test strips in a vial, but 100 would fit, at 4 per day that's 25 days.

The plastic containers that I use for sharps last me about 27 days, one to contain new needles and lancets, and another for used.

Alcohol pads are easy.

For planning purposes use map man's section hiking rates to template out where you might be every 24 days or so and plan a drop box at an appropriate place - avoid the PO that may be closed, etc - use Baltimore Jack's resupply information.

Yes, you could carry twice as much and resupply half as often. Yes, you might test more often, test strips are light, carry more. Yes, you might use less insulin, be flexible and extend the resupply interval.

The drop box would have insulin pens, alcohol pads, needles and Lancets (in a sharps container) - and other stuff, like food.


BD Diabetes Products has sharps disposal guidelines by state - http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=10284 . In general, opaque, hard shelled, labeled and taped - every state is a little different.


Am I overthinking this or what? What has worked for people?

Jeff Kindy
10-29-2013, 00:44
Well I figured someone had to have made this and they did. A virtual hike along the AT! You download the app, hike and the miles are logged on the trail! There seems to only be two maps so far. But this is too cool!
https://play.google.com/store/apps/details?id=com.virtualwalk.android

Jeff Kindy
10-29-2013, 00:45
BTW Type 2 Insulin dependent here planning on section hiking the AT starting next April with my son who is legally blind. He is going to thru hike the AT next year!

Tuckahoe
10-29-2013, 06:16
Cut back on your sugar,

I am sure he has his own meal plan, long ago discussed with his Dr.

RangerZ
10-29-2013, 13:05
Believe me, I watch the sugar. I'd say I haven't had any in over a year, except cooked in food. Splenda is my friend. I'm well controlled T2, numbers average around 100 with A1c of 5.1.

TheYoungOne
11-11-2013, 16:46
RangerZ , If it helps any there was a diabetic guy who completed a 2013 NOBO thru hike with his wife and dog. His trail journal and Youtube videos mention his condition here and there, but you may want to contact him directly to get some advice. Good luck. http://www.trailjournals.com/entry.cfm?trailname=14991 http://www.youtube.com/user/TeamFortisAT?feature=watch

Options
11-26-2013, 13:38
Lala1008, the pump vacation was a success. My bg's were ok. I was reminded quickly though that the pump is far superior for my management style. As it now stands I will hike with the pump and carrying pens for emergency backup, in case of pump failure.
Robin2013AT I was able to get up with M80, and yes he is a remarkable guy. Extremely accommodating with good advice. The Team Fortis youtube posts have taken up quite a bit of my time lately.

squeezebox
11-29-2013, 22:50
please wear a necklace or bracelet , if we find you passed out we'll know what to do.

RangerZ
12-09-2013, 23:29
How goes the planning for your thru? I'm still looking for any wisdom to be had.

Options
12-19-2013, 10:30
As of today the Thru is still on. Still looking at a mid Feb. start date. The excitement is starting to build as the dream comes closer to reality. 2014 guide is on order, reviewing pack weight and trying to reduce poundage, researching different infusion sets for the pump and resupply points for meds. I'll constantly have to fine tune my carb/insulin ratios once I'm walking. For that reason I'll always be a little heavy with food. Anxiety builds on the home front, so also dealing with that.

@Squeeze, I'll be lit up with diabetes identifying info. Currently planning on having a blaze orange med alert bracelet as well as a necklace. Also have had the suggestion to get a medic alert tat. We'll see.

Options
12-19-2013, 10:33
Forgot to mention that the ATC has provided me a list of past diabetic thru hikers. I've been in contact with some of those individuals who have also provided great insight and advice.

RangerZ
12-19-2013, 19:41
Forgot to mention that the ATC has provided me a list of past diabetic thru hikers. I've been in contact with some of those individuals who have also provided great insight and advice.

Options,

Could you share some of your planning about med resupply. Could you share the list of past thru hikers or send me the ATC POC with the info. PM me if you have to. Thanks.

It looks like its going to be 2016 for me. I haven't advanced the planning that I've shown above (work interfers with what I really want to do with my life).

I have logged over 1100 miles on local trails this year, I'd be just north of the PA turnpike on the trail.

Options
12-19-2013, 20:54
RangerZ,

I contacted info@appalachiantrail.org and requested a listing. There is a FAQ tab on their home page that provides a lot of information for hikers.

Options
12-19-2013, 23:35
As for my med re-supplies, I'm waiting on AWOL's 2014 trail guide before I finalize. Tentatively looking at a resupply every 25 days or so for my pump supplies, with a bounce box to supplement. With the insulin pens as a backup I could stretch it out for quite a while, especially if my insulin requirements drop as much as I'm anticipating. The hikers I've discussed this with claim to have reduced their insulin by half while hiking. Just on my short section hikes I believe I'll stabilize around that mark as well. We'll see.

Options
01-05-2014, 22:55
Watching the weather. Currently planning to start on 16 FEB. Follow me at http://trailjournals.com/entry.cfm?trailname=14338

RangerZ
06-01-2014, 20:40
I want to start a thread about the logistics of thru hiking with diabetes. I'm looking for some wisdom about maildrops, etc - I think nutrition is being well covered in other threads.

I am thinking about / starting to plan a 2015 (or later) thru hike.

My thoughts run like this, the insulin pens set the resupply interval. I go thru a fast acting pen in about 16 days and a long acting pen in about 11 days. The common denominator of those two numbers is about 32 days (2 fast acting pens and 3 long acting), with a factor of safety say a resupply after 24 days.

I get 25 test strips in a vial, but 100 would fit, at 4 per day that's 25 days.

The plastic containers that I use for sharps last me about 27 days, one to contain new needles and lancets, and another for used.

Alcohol pads are easy.

For planning purposes use map man's section hiking rates to template out where you might be every 24 days or so and plan a drop box at an appropriate place - avoid the PO that may be closed, etc - use Baltimore Jack's resupply information.

Yes, you could carry twice as much and resupply half as often. Yes, you might test more often, test strips are light, carry more. Yes, you might use less insulin, be flexible and extend the resupply interval.

The drop box would have insulin pens, alcohol pads, needles and Lancets (in a sharps container) - and other stuff, like food.


BD Diabetes Products has sharps disposal guidelines by state - http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=10284 . In general, opaque, hard shelled, labeled and taped - every state is a little different.


Am I overthinking this or what? What has worked for people?



I started this thread over a year ago and some things have changed. I've been well controlled (A1c ~ 5.2) and graduated from fast acting to Victoza. Decreased from five injections a day to just two, Victoza and Levemir.

My suggested resupply interval remains at 24 days, carrying 3 pens of each.

I've also started reusing pen needles for two days, four injections; and lancets for two days, eight tests. And stopped using alcohol pads. Heresy, I know, but it's working for me. YMMV, HYOH.

I usually test every hour when I'm out dayhiking.


I'm not doctor and I don't play one on TV or the internet, but it's my professional engineer opinion (which has no merit in this case either) that Victoza works.


My virtual NOBO AT hike (assigning local miles to the AT) has me at 1598 miles (just into Vermont) in 17 months. I have a 13.3 mile route that's become my typical weekend dayhike. Yesterday I did 14.8 miles exploring a new addition to the route. It's nice coming back to RangerZ's Squirrel Hill hostel every night. Since it looks like 2017 may be the year, at this rate I might be able to finish a virtual SOBO also. Still waiting for GoogleEarth to get StreetView for the AT.

GalliaType1Hiker
04-29-2015, 01:34
Can't believe that you even still take insulin as a type 2 with such an awesome A1C. I am Type 1 with a not so good A1C which of course I will get in better check before trying something add bold as the AT. I was wondering what the pros and cons are of insulin pens vs. Insulin pump. Any contacts, resources, or information will help immensely. Thanks in advance ď

RangerZ
12-15-2017, 23:11
OK, I’m bumping this thread again. 2018 is the year for me, 10 or 11 April onSpringer. On 3 January I’m taking careof my pesky work problem; I’m calling it a career at 35 years.:banana
<o:p> </o:p>
I’ve taken a relook at my diabetic resupply plan. I’m still planning a 24 day resupplyinterval. Start with a load at Springer,then five resupplies – Bluff Mtn Outfitters in Hot Springs, 4 Pines Hostel inCatawba, Carlisle during a conjugal visit, Dalton PO, and Pinkham NotchVisitors Center. These are all on(close) to the trail, I don’t want to go far off the trail to resupply. I recognize the problem with the Dalton PO,what’s a close alternative location?
<o:p> </o:p>
I’m still well controlled, my last A1c was 5.0. I will admit to getting complacent - I don’ttest four times every day, I reuse needles for two days, four injections, and Ichange lancets only weekly. It works forme, YMMV, HYOH. I don’t do special testsduring hikes.
<o:p> </o:p>
I’ve put together a sample resupply box using a US PO smallflat rate box, about the size of a big paperback book. Six pens, a small (3” tall, 2” diameter) pillbottle, 17 needles, 5 lancets, two vials of test strips (100 count), 33 smallziplocks with AM pills, 33 small ziplocks with PM pills. Needles and lancets get packed into the pillbottle for mailing, then go into a snack size ziplock. The pill bottle becomes a sharps container,pre marked, with a small super glue vial and duct tape to seal it when full. A quart size ziplock to put everything in aftertaking it out of the mailing box.
<o:p> </o:p>
My wife will mail them when I’m about a week or so from theresupply point.
<o:p> </o:p>
I keep my active pens and needle in my “don’t lose it in thetent bag” (the mesh bag my SnowPeak pot came in) along with the glucometer andlancer. In hot weather I use a Friocase. I sleep with the pens, glucometer,phone, external battery, filter, fuel, etc when its freezing, the sleeping baggets crowded.
<o:p> </o:p>
<o:p> </o:p>
I’m still looking for any wisdom from anybody who hasactually dealt with all of this on the trail.

Options
02-04-2018, 17:37
RangerZ congrats on "taking care of that pesky work problem" and good luck on your thru. I'm still pushing north albeit as a section-hiker. I'm heading out of Pearisburg in a few weeks. With luck we may cross paths somewhere during the journey. Happy Trails!!

RangerZ
02-06-2018, 22:27
RangerZ congrats on "taking care of that pesky work problem" and good luck on your thru. I'm still pushing north albeit as a section-hiker. I'm heading out of Pearisburg in a few weeks. With luck we may cross paths somewhere during the journey. Happy Trails!!


Options,


Thanks for the good words. Retirement is: no alarm clock at 5 AM, no riding buses, no deadlines (except 9 April on the Approach Trail), no employees, 27 barges break loose and jam up at a lock and dam - not my problem!


Can you provide some specific info on how you are handling logistics? I remember that you use a pump but pens sometime. Per my above post I've worked out resupply points. How are you handling disposal of pens, needles, test strips, etc? What has worked for me at home and traveling is small pill containers (hard sided and opaque) marked, glued and taped shut. PM me if you want to stay private on some of this.

RangerZ
07-16-2018, 17:23
OK, Iím bumping this thread again. 2018 is the year for me, 10 or 11 April onSpringer.On 3 January Iím taking careof my pesky work problem; Iím calling it a career at 35 years.:banana
<o:p>Iíve taken a relook at my diabetic resupply plan. Iím still planning a 24 day resupplyinterval.Start with a load at Springer,then five resupplies Ė Bluff Mtn Outfitters in Hot Springs, 4 Pines Hostel inCatawba, Carlisle during a conjugal visit, Dalton PO, and Pinkham NotchVisitors Center.These are all on(close) to the trail, I donít want to go far off the trail to resupply.I recognize the problem with the Dalton PO,whatís a close alternative location?
<o:p>Iím still well controlled, my last A1c was 5.0. I will admit to getting complacent - I doníttest four times every day, I reuse needles for two days, four injections, and Ichange lancets only weekly.It works forme, YMMV, HYOH.I donít do special testsduring hikes.
<o:p>Iíve put together a sample resupply box using a US PO smallflat rate box, about the size of a big paperback book. Six pens, a small (3Ē tall, 2Ē diameter) pillbottle, 17 needles, 5 lancets, two vials of test strips (100 count), 33 smallziplocks with AM pills, 33 small ziplocks with PM pills.Needles and lancets get packed into the pillbottle for mailing, then go into a snack size ziplock.The pill bottle becomes a sharps container,pre marked, with a small super glue vial and duct tape to seal it when full.A quart size ziplock to put everything in aftertaking it out of the mailing box.
<o:p>My wife will mail them when Iím about a week or so from theresupply point.
<o:p>I keep my active pens and needle in my ďdonít lose it in thetent bagĒ (the mesh bag my SnowPeak pot came in) along with the glucometer andlancer. In hot weather I use a Friocase.I sleep with the pens, glucometer,phone, external battery, filter, fuel, etc when its freezing, the sleeping baggets crowded.
<o:p><o:p>Iím still looking for any wisdom from anybody who hasactually dealt with all of this on the trail.



Bumping this thread once again.
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I started the approach trail on 9 April and left the AT on 3 July in MD with a knee problem (I know, so stereotypical).
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My diabetic resupply plan worked largely as I wanted.
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I had diabetic resupply boxes sent to Laughing Heart Lodge in Hot Springs and 4 Pines Hostel in Catawba; the next one would have been to Boiling Springs.
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I had two problems.
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First, the plan assumed that I would leave Springer with 3 pens each of Victoza and Levemir. The reality was that when I started I only had 2 each on hand due to the mail order pharmacy resupply interval. This necessitated a call to the mail order pharmacy and a request to advance the mailing date. So, a normal resupply box to the Quarter Way Inn included pens also, enough to get me to Harpers Ferry (I actually ran a little short of Victoza the night before I got to Harpers Ferry); a normal resupply box at Harpers Ferry included a pen each to get me to Boiling Springs.
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The second problem involved test strips. When I was still working I put my daily use test strips in a small ziplock bag to avoid the bulk of the little black vial.I started the trail the same way and test strips started failing before Hot Springs. The reason had to be too much exposure to theenvironment Ė heat, humidity and moisture. After Hot Springs I kept them in the vials and didnít have any problems; the vials have an inner lining which I assume keeps them Ďfreshí.
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The other part of the resupply Ė needles, lancets, pills, etc Ė went off as described without a hitch. The only difference was that I put all the daily pills into one small ziplock instead of having AM and PM ziplocks. I didnít consistently test four times a day so I had left over test strips. Used pen needles, lancets and test strips went into the pill bottle which was glued, taped and disposed of when full; I discretely disposed of empty pens.
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I slept with my glucometer, lancer and test strips. Morning testing was one of my Ďstill in the sleeping bag choresí (along with checking the weather, mail and news when I had a signal). I kept the pens in my Frio case, in the sleeping bag when it was cold (27* on Tray Mtn on 16 April) and just in the tent after it warmed up. When it got hot in VA I soaked the Frio case and kept it snuggled up against my water reservoir in my pack.
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I ate indiscriminately while on the trail, typical hiker food Ė Knorrs rice sides, mac and cheese, tortillas, Snickers, nutty bars, cheese burgers and onion rings at the SNP waysides, etc. In mid May and June, I looked at my three day morning fasting averages, both times they had dropped into the 80s. I reduced the Levemir and they increased back into the 90s. I did not change the Victoza injections or stop the Metformin. I did send this info to my doctor and he concurred.<o:p></o
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I lost 39 pounds from Springer to Harpers Ferry; believe me, I had it to lose. I had to buy a new pair of pants in Waynesboro, VA, the old ones would not stay up without a belt. Iíve lost an additional 6 pounds after coming home, so far Iíve kept it off.<o:p></o
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I didnít have any problems with resupply boxes in the mail or at the hostels.
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The current plan is to continue to treat the knee, hopefully avoiding surgery, hike some locally to test it out and maybe finish MD and PA in the fall. Iíd like to at least get to the halfway point. Then, if all is well, finish the AT next year.</o</o</o</o</o</o</o

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07-21-2018, 09:22
Thanks for the update RangerZ and congrats on your progress up the trail. Sounds like your logistics worked out pretty good. Hate to hear about the knee though. Hope it heals up. Keep us posted.