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  1. #1
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    Default Diabetic thru hiking logistics

    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.a...=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?

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    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.

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    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.

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    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.

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    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.

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    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?
    The more miles, the merrier!

    NH4K: 21/48; N.E.4K: 25/67; NEHH: 28/100; Northeast 4K: 27/115; AT: 124/2191

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    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.

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    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.

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    Quote Originally Posted by Options View Post
    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.
    The more miles, the merrier!

    NH4K: 21/48; N.E.4K: 25/67; NEHH: 28/100; Northeast 4K: 27/115; AT: 124/2191

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    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.
    "Chainsaw" GA-ME 2011

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    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?

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    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.

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    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.

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    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 .

    Sharps Disposal.pdf

    It's everybody's responsibility to act responsible.
    76 HawkMtn w/Rangers
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    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.
    76 HawkMtn w/Rangers
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    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.
    76 HawkMtn w/Rangers
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    14 LHHT
    15 Girard/Quebec/LostTurkey/Saylor/Tuscarora/BlackForest
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    17 BearR
    18-19 AT NOBO 1540.5

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    All that and I forgot the attachment.
    Attached Files Attached Files
    76 HawkMtn w/Rangers
    13 HF>CramptonsG
    14 LHHT
    15 Girard/Quebec/LostTurkey/Saylor/Tuscarora/BlackForest
    16 Kennerdell/Cranberry-Otter/DollyS/WRim-NCT
    17 BearR
    18-19 AT NOBO 1540.5

  18. #18

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    Quote Originally Posted by RangerZ View Post
    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!

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    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.
    76 HawkMtn w/Rangers
    13 HF>CramptonsG
    14 LHHT
    15 Girard/Quebec/LostTurkey/Saylor/Tuscarora/BlackForest
    16 Kennerdell/Cranberry-Otter/DollyS/WRim-NCT
    17 BearR
    18-19 AT NOBO 1540.5

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    Quote Originally Posted by Swordpen View Post
    do you have a link on the virtual AT trail?

    Thanks!
    I'm waiting for Google Earth to get Street View for the trail.
    76 HawkMtn w/Rangers
    13 HF>CramptonsG
    14 LHHT
    15 Girard/Quebec/LostTurkey/Saylor/Tuscarora/BlackForest
    16 Kennerdell/Cranberry-Otter/DollyS/WRim-NCT
    17 BearR
    18-19 AT NOBO 1540.5

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