Embarking on the most incredible journey of my life. a year after open heart surgery and almost 40 years of living with Type 1 Diabetes, I set out to achieve what seemed, for many, and even myself, the impossible.
Editor’s note: My friend Sandra and I met John, a 57 year old from Missouri, on our Camino last year and were so inspired by his attitude and courage, walking the Camino Francés with Type 1 diabetes, that we invited him to write an article on how he did it. Here we are enjoying the menu del dia at Navarrete with him. John was formerly a computer analyst for over 20 years and continues to live on the 100 acre family farm.
To go back a little… Travel has been an all-consuming passion for most of my life. I started travelling through Europe at 15, with limited funds and only my determination and will to keep me going. I love the adventure, doing something new, and proving that no matter what, you can! It was with a great deal of reluctance that my father and very worried mother let me go on such a journey alone. I took a backpack and a map and backpacked through Europe for two months.
At 17 years old I was diagnosed with Type I Diabetes and thought my travelling days were over. At the first moment I was diagnosed with such a limitation on my daily life, I was of course depressed. I always felt my days were numbered, feeling as if I had a huge chain around my legs. However, I never let it hold me back from living each moment full on and in fact travelled around the world within a few months of the diagnosis.
So, almost 40 years later, I found myself starting a journey that I wasn’t sure I could complete or even live through. Then, 38 days later, I did it! I made a journey of miles that even I questioned if I was able to do because of my diabetic condition I had always believed to be a limitation. At the end of the Camino trek, I found myself both at a major ending of a transcendental journey and a new beginning in life. How did I do it? Would other people living with diabetes not only be encouraged by my story, but realise that there are truly no limitations other than those we accept?
Looking back on my Camino and keeping myself healthy…
When I first started thinking about doing the Camino my concerns were many. How would I handle the parameters of being diabetic? What would I need to do
to manage meals/food, low/high blood sugars, carry enough supplies for almost 2 months, and keep the insulin cool. I found online the EasyBag from Mediativ.com which keeps insulin cool between 16-22°C for up to 5 days. This small, single bag held 6-7 bottles of insulin.
I had been planning this trip for well over a year to walk 500 miles from St JeanPied-de-Port in SW France at the foothills of the Pyrenees across northern Spain. However, for some months, I had been short of breath when walking, hiking up hills, and working around the farm. The cardiologist informed me that I had a bad aortic valve that would need to be replaced. I found out this news in June, 2014 and my Camino trip had been planned for September, 2014. I scheduled open heart surgery and postponed the trip until August, 2015.
So, finally, between August and September of 2015, I hiked the 500 miles during my pilgrimage across Spain to Santiago. The path led me across mountain ranges, rocky patches, and rough terrains. A year ago the idea of walking across Spain had been on hold after open heart surgery. What was once an idea, a passion, and an incredible possibility against obstacles is now a personal victory.
As a Type I diabetic on a 500 mile walk, I was checking my blood sugar 10-20 times a day, walking 8-10 hours per day. Walking the Camino, for a diabetic, is like going to the gym every day for 10 hours over 38 days in a row. Each day the body is burning energy and replenishing with important fruits and carbohydrates. At the end of each day, the body is still continuing to burn energy all night because of the previous 10 hours of working out.
I had to cut my insulin back 60% at night so I would not have low blood sugars. A critical habit as a Type I diabetic is to have fruit next to you at all times within a foot of where you are. Even on the night stand. I have had enough low blood sugars in my lifetime that impact my mental thinking to know that I must maintain enough mental acuity to know to get important life force energy in as soon as possible.
Walking out of Logrono
The Camino was life-changing in many ways. I was in pain and my body was hurting almost every moment. How-
ever, it only added to the ‘joy’ of feeling alive in the physical body that we are all blessed with. The mountains I crossed were steep, cold, wet, and very high. I could not give up. I could not allow myself to quit. I could never give up because of the important reason I was doing the Camino. We never know what we are capable of if we never push ourselves. We may feel like giving up, but if we don’t keep going we will never know what is just around the next corner.
The excessive daily load I placed upon my body and especially my feet created a major hurdle to overcome every single moment. I actually did quite well. The extremes in weather i.e. the cold in the mountains and especially the heat on the Meseta burned a great deal of calories. The fruit I carried helped keep me alive. At the end of each day I would arrive in the next village and stay in the albergue. All travellers were provided a meal of spaghetti and meatballs, salad, chicken, or a pork steak. These meals were somewhat well balanced and served to provide adequate carbohydrates and necessary nutrition for each day.
John and Ali at the Cruz de Ferro which occupies the highest point of the entire Camino Frances. The site consists of a tall wooden pole topped with a iron cross. This is said to be an ancient monument, first erected by the ancient Celts, then dedicated by the Romans to their god Mercury (protector of travellers) and later crowned by the cross and renamed as a Christian site by the 9th century hermit Guacelmo. For centuries, pilgrims have brought a stone to this place from home to lay down their burden, leaving them lighter (literally and figuratively) for the journey ahead.
At each breakfast I would take a bolus of 5 units. At the end of a day of hiking I would need 8 or 10 units. Breakfast generally consisted of bread, Danish, and fruits. If it was available, a few days a week I loved a big breakfast of eggs, meat, sausage, toast, and of course fruit. A breakfast like this provided enough carbs and nourishment to hold me over until the several miles to the last village for the day, arriving around 4-5 pm. I spent the night in the village and had dinner around 8-9pm. Dinners at the albergue are some of the best memories as the other pilgrims would tell their stories and we would have a great time. I turned in every night around 10-11pm or even later when I was writing my story for the week. At this time I would decrease my insulin by -60% for the insulin pump until the next morning. I was walking 15-20 miles each day; however at night my body was still burning energy.
I found I needed to shut my insulin pump down by 10am and not turn it on again until 4pm when I would have a sandwich and fruit. My hourly basal rate now would be 1.5 units per hour and a bolus of 4 units for this afternoon snack. My bolus for dinner would be 9-14 units depending how big the dinner was and if I was very hungry. Before my Camino and back home, I would usually have a bolus of 20-25 units of insulin for dinner.
The village of Moratinos the sign says 376km half way there!
In the midst of the journey I found myself burning 30004000 calories per day. The primary concern as a diabetic is to have enough carbohydrates and fuel to make it from village to village. I started out each day around 7am. It was crucial to plan the night before for the next day’s body fuel supply. The stores in Spain weren’t open until 9 10am and closed by 7pm. Getting ready and having food was one of the main stressors each day. As a diabetic, you cannot be out of the food necessary to
prevent low blood sugars, coma, or death. Living through this extreme toll on the body on the difficult passages of Spain was possible many times because of one piece of fruit! I could find myself miles from the next village and down to 1 piece of fruit with a blood sugar at 60. I had to calculate carefully how far to each village and what I would carry in my day pack to get through. The delicate balance of my body, stress, and mental anguish also would create even lower blood sugars, so it was important for me to remain calm. Careful preparation gave me confidence to get through each mile during the day.
The stress of making sure I had everything in my backpack to survive the upcoming journey was a major draw on my mind and my wellbeing each day. Being without just one piece of fruit could have meant death. It was essential for me to prepare the night before by stopping for supplies at the local market before it closed for supplies that were crucial for life. My biggest fear was often that I would not have the supplies on board. Understanding that additional weight on my back also made the journey a little harder so it was definitely a delicate balance to achieve.
The trail can be daunting while overcoming stress, worry, and physical limita tions. I had been behind a desk for almost 20 years but the farm definitely helped to keep me in shape. Overcoming the heart surgery and recovering my strength meant everything. Out on the trail I had to consider that there is no ambulance, and even if I dropped, it could be an hour before someone comes across and another hour until help. Just as in daily life but even more critical… preparation is key… plan ahead! It was vital to my success to stay in control of emotions as well as stress and keep calm,
I understood that I have an organ that does not work properly. It is as important as the liver, kidneys, and the heart. When the pancreas doesn’t work properly or even gives out, then you have maybe 5 minutes to address a low blood sugar. I planned ahead as I always do in daily life because I understood that with Type 1
or possibly even Type 2 diabetes, I have 5 minutes to take care of it. The stress ensues when 5 miles from the next village you realise you have eaten the last orange. I continued to maintain my calm and to be prepared.
One problem I had was forgetting to turn the insulin pump off during my hike. I left each day after having breakfast, everything in my pack for the miles ahead, and I would forget to shut the insulin pump off. Of course under normal conditions and daily exertions I don’t need to worry about shutting the pump off completely but I was using so much energy and burning up some many calories and carbohydrates that the extra insulin wasn’t needed. I would find myself suddenly feeling ‘funny’ and became even more aware of my body and noticed my thought process was not making sense. Then I thought, “I forgot to shut the pump off!”. I shut it down and immediately grabbed some fruit.
Watching blood sugars was critical. Daily walking of the Camino took 8-10 hours. The journey included crossing three mountain ranges and many days over the dry and hot Meseta. Blood sugar monitoring was especially critical because of fluctuations in temperature from extreme cold to heat. Calorie intake had to be monitored and consisted of good carbohydrates and fruits. The point is that it can be done with preparation, balance, determination, and most of all, discipline.
Summarising the journey…
I’ve arrived! Santiago, east side of the Cathedral, 26 Sept 2015
Many people I met called me ‘Missouri John’. I loved the comradeship and the feeling of meeting hundreds of people over the journey who are instantly best friends and will do anything to help and support one another. Dinners at the al bergue are some of the best memories as the other pilgrims would tell their stories and we would have a great time. I have gained new friends from all around the world. We are the same. Just loving and caring people on a life journey.
On the days of over 20 miles per day, the last few miles were the hardest. It was during these times I would see another steep hill or small mountain ahead and say, “OH, COME ON”! Some of these long days were often 7-9 hours of hiking. I would arrive last at the albergue and all my new friends and people who saw me from the hike would all yell, “JOHN!” I would raise my hiking stick in the air as a cheer or sign of a victorious day. In the 38 days I walked the Camino, I experienced profound spiritual moments daily. I thought of mom and dad each day and when I needed help—seriously needed help—to continue, I would look up and ask for it.
I feel so fortunate to have met so many great and wonderful people on The Way. I met Patty and Stephen from Australia, Ali and Sandra from Australia, and Den ise and Ralph from New Zealand. These are examples of people who care deeply about others and gave me support. Whenever they saw me struggling or suffering they were there to help. When I talked to these and other pilgrims about my Camino and the story of my parents, everyone could relate. They were always inspired by mom and dad’s lives. Many people would often tear up when I told my stories about my parents and reasons for doing the Camino. The Dutch and French loved my jokes no matter how many times I told them, over and over.
Today I still think to myself in amazement, “Did I just walk the Camino”? Then I dig into my pack, pull out my pilgrim’s passport and look at the stamps from the albergues I stayed at and churches I visited.
I have over 2000 pictures of the friends, the great times and the incredible sights along the Camino passage. I have precious memories and photos of the commemorative moment in Santiago. Finisterre, a fascinating corner at land’s end, on the Atlantic Coast, was an incredible ending point to my Camino. At the symbolic lighthouse, I placed photos of my mom and dad and left chips of stone from the grave headstone from their resting place in Camden Point. The prayers and words of encouragement from many friends were always there for me and helped me to push on when I thought I had nothing left.
Solvitur ambulando means “Walking solves all”. Evidence has shown people on the move are happier and more peaceful. I think I have another Camino in me. Even though I am still asking myself, “Did I just complete the Camino?” On the Camino people are doing the pilgrimage for different reasons. One person said to me he was running away from something or to forget. My thought is that it is impossible to run away from yourself because you are the first person you will see at the end of the day!
As difficult as this was and how bad I felt at times, I still could never quit. I had the reasons I started my pilgrimage to push me forward. For me there was never a choice of doing this half way or allowing myself the option of finishing the
journey another time. Many people choose this option as the fatigue and mental stress take over. But once you consider the next step is always the best one, take time and enjoy the journey.
I realised that the meaning of life holds truth. Everyone is always on a journey or path that takes them far and wide against the grain. The Camino helped me to see the truth as my body felt every step and allowed me to look at what is available and what is limiting me now. I allowed myself to exist in peace and live amongst the ruins of a tortured journey that has been passed by mil lions. Each learned as I have, that every day is a new day, and may wonder… how much longer? We often must change and end the way of life that is before us now. This journey, and those to come, help find the true self and the rite of passage.