T1D – 18380ft. – Journey to the Top

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Mahatma Gandhi once said that strength does not come from physical capacity, it comes from an indomitable will.

Being one of the only 2 out of 14 people to attempt to cycle up the Khardungla pass (highest motorable road in the world) inspite of having Type 1 Diabetes (T1), hence proved?

PREFACE

Once upon a time in college, I used to be a really active lad. Although I wasn’t very upfront about my type 1 diabetes my friends would see me injecting myself, eventually figuring it out and instantly ask me, “Wow! You still do everything?” Ofcourse I could still do everything, what or who was going to stop me?

fat boy cyclying 2After I passed out of University, I realized that I was rapidly gaining weight. At one point I almost reached 100 kgs and had an HbA1c of 7.4…this is when I decided to take things in my hand and started cycling with an objective to lose weight.

I enjoyed my regular bike rides. After being a T1 for 20 years, I’m now well aware of my hypo and hyper symptoms to take necessary precautions. But don’t get mistaken, there is no such thing as a perfect world. I still remember this one day during my general ride when I started lagging behind on dingy roads. When in a hypo, my mind starts down talking to me and I start questioning my abilities, so I immediately realized where I was headed. I asked people on the road for sugar or water but no one seemed to be keen enough to help me out, I don’t blame them because they didn’t know the criticality of the situation. I kept going ahead till I caught up with one of my cycling mates and gulped down his electrolyte. Stories apart, I cycled regularly in Jan, Feb and March (2016) and in May and April started doing functional training to get my upper body toned and in sync with my lower body. salad-with-egg-and-meatDuring this period, to accentuate the results, I cut down on all direct carbs (Rice, Roti), ate 6-8 eggs a day, lots of fruits and veggies and a glass of milk for dinner, basically replacing carbs with proteins. Bottom line is that I kept timing, exercise, Insulin and food at its optimum with a close watch.

When it comes to more detailed diabetes management, I took advice from Ruby and Dr. Sachindra for my main concern: How to avoid a delayed Hypo post ride completion? I had to adopt a trial and error technique. I eventually stuck to Milk, Fruits and Khajur-Chana laddus as I was sure these work for me. They had also advised me to eat fats to keep sugar from dropping. I’d also have 25grams of protein powder in 300ml hot milk with biscuits and only bolus for the milk and biscuits.

Like I said, as time passes and with a close watch I figured out what works for me.

I even got onto a pump because I was getting more active and my food regimes were changing. I was going into post work out delayed hypos so switching to the pump gave me the ability to take insulin when I eat, basically, flexibility.

Another key thing is to check blood sugar readings. In college I use to check my sugars thrice a day, now on a normal day I check 5 times a day and during my ride in Leh I’d check close to 8 times each day. Most often you get symptoms of off sugars, and it is very important to check to reconfirm the symptoms. So when in doubt, always check! To feel and know your low is one thing, it is important to know how low you are so you can eat appropriately. I always carried a box of glucose gel pouches for the ride, luckily didn’t have to use too many.

Inception of the idea of the ride? The very inspirational Arun Bodas (whom I refer to as Dada), a T1 himself, who rode from Manali to Leh at the age of 50 without the pump. If he can, why can’t I?

I registered for the ride!

I was told to do atleast 4-5 100km rides and do incline practice. My first ride post the registration was a 15kms one to the JDF clinic and back. I consulted the psychiatrist there because I was doubtful if I’d made a feasible decision. I was told that fear will push you more and not hold you back. So I built it up slowly…from 180 kms in week 1 to 320kms by week 6 and interim I completed atleast 6, 100+km rides.

Needless to say, weight-loss was no more my motivation…now it was just the drive to achieve the goal I had signed up for.

THE RIDE!

Although my ride started on day 5 of my trip, let me just take a moment to tell you how disastrous my day 1 was…very disastrous. First my patch came out so I had to rush back to my hotel, then when I took a correction dose to fix high sugars my pump started showing a motor error. I tried multiple times to reset and self-test the pump, thanks to the Vocal Guidance from Muslim Kapasi, and take a bolus as my sugars were now hovering around 400 but the damn thing would just show an error. I was in panic mode, how would I be able to do my ride? Thankfully Medtronic sent me a stand-by pump in time and I was able to control my sugars with pen shots until then. Yes, disaster!

Day 1 of the ride was a test journey. We were 14 of us, 6 from Delhi, 6 from the Navy, 1 from Hyderabad and I! It was pouring on this day. I had anyway been practicing in the rains so it wasn’t too much of a problem. The challenge was to keep yourself active and avoid cramps by not over straining. The cold weather posed its own challenges on top of the uphill climb. We completed 40 kms on this day of constant incline to reach Marhi i.e. Base camp 1.

My motto throughout remained- One turning at a time!

IMG_1475Since it had been raining all night, we were all dreading the weather that we’d have to deal with on day 2. In the cloudy weather on day 2, I was still excited. Maintained my rhythm not exerting too much. My goal was to reach the top and that kept me going. It was all fun until all my body parts started hurting eventually. By the end of day 2, we were at Sissu having covered another 55 kms.

In the woods along the riverbed, we rushed to a waterfall’s base and quickly washed our cycles that evening.

Day 3, we were passing through Keylong to make it to Jispa, fatigue since the last two days had started setting in. The Maharaj at Jispa decided to make hot pakodas and nobody can say no to those, especially after a long and tiring 70kms ride. I had to change my patch that day post the ride, and as a precaution I check post meal sugars to confirm that the patch is working fine. Although by evening, I was puking my guts out thanks to the tasty pakodas. Substantial water loss and fatigue enhanced my weakness and taking rest was the only practical decision.

Mom and Dad had requested the manager of my troop to stay with me in a tent to detect overnight hypos (I start grunting when I’m hitting a low in my sleep); luckily he took good care of me. Since I was sick I rested on day 4 in the recovery van and resumed riding from day 5 onwards.

IMG_1390Day 5 was all about rocky mountains, snowy peaks and the river below. We covered 60 kms to make it to Sarchu.

The key for me was to keep my physique well maintained, a continuous journey has little scope for rest and it’s important to not over-strain. Although the rest I took yesterday was ideal as it helped my muscles and me recover better.

Day 6 was the most difficult as we had to ride through 3 passes; namely- Gata Loops, Nakeela La and Lachung La. I took a break after Gata Loops to realize that my sugar reading was at 250 so I adjusted my bolus and basal.  I was constantly wavering towards higher sugars when I thought it would be the other way around, I felt like the climate could have hampered my sensitivity.

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But I later realized that sometimes, exercise triggers the body to release stress hormones, like adrenaline, which stimulates the liver to release glucose, or cortisol that makes you more resistant to insulin. And strenuous activity, especially competitive sports, triggers increased stress hormones, in which case blood glucose more often (at least temporarily) increases. Yes, not kidding!

Day 7 was a relaxed day so jumping to day 8 where we were attempting the second highest motorable road in the world, Tanglangla.  My mates would look at all the equipment I’d need for diabetes management, observe keenly as I changed my patch to end up feeling like it’s a tedious job. They’d eventually say, “Maanana padega yaar! Inspite of all this you have been riding strong”. Which only made me feel stronger.

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Throughout the ride I did not overthink Diabetes. It didn’t matter if it wavered a little high, I didn’t let it interfere with my line of focus.

We were all a motivation for each other to reach the top. Once we reached all my ride mates gave out an achievement shout but I didn’t, I was yet to achieve my goal. Satya Pal, a rider from Delhi who was keeping a constant check on his heartbeats was able to reach the top too and we both took a break together after the downhill, taking our time to enjoy the landscape around us. Even though I was the 5th person to reach Tanglang La top, I was the last to reach the base camp at Upshi.

Reaching Leh meant nothing to me, I wanted to go up till Khardungla! My preparation had always been for Manali to KhardungLa, and not Manali to Leh.  Praveen and I were the only two in the group who were up for this challenge. We had decided to cycle upwards with no back-up vehicle, and stuck with that decision. We took a day’s rest for the challenge of riding 40kms up to Khardungla and 40kms back down. Quite honestly, I was obviously VERY tensed! To put things in perspective, we were to gain 8000ft in 40kms, which is 200ft/ km average.

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Finally the day came. The road initially was alright but after 10-15 kms it start picking up a steady gradient. I kept going slowly-slowly, one km milestone after another. Praveen and I were extremely tired after 26 kms and we contemplated taking a lift in a car till the top. But I was so close to my goal now that giving up was out of the question. “No Shortcuts!” Somehow, during our meal break, we motivated each other and continued.

The last 10 kms was the most difficult because of the seriously unpaved roads. Bad roads, steep incline, exhaustion and very little oxygen. Had to keep dragging my cycle and myself through the last 5 kms, questioning my decision to ride. Praveen was 30 mins ahead of me.

Kept pushing myself and finally saw the rock and flag to identify it as my entry! 600 meters from that turning and I ultimately reached the board I had been dreaming of. I had achieved my goal and this called for the loudest achievement shout anyone would have ever seen in the history of mankind! I let out all my mental and physical exertion and people around came to give me a much needed hug…I was in tears! After 10 hours I had reached the top. I thanked God at a Mandir there. The feeling was truly overwhelming.

I was then unstoppable so I rode back down with the wind beneath my wings at 60 km/hr speed and shouting out to the valleys. I was having conversations with the peak and telling her how its been the best challenge I have faced, telling her how she may have broken down many a people but not me, not today, because I’m tougher!

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ENDING NOTES

As someone with Diabetes, ofcourse there are limitations and restrictions that we have because of the disorder we face, but you have to accept it and see it as a part of you, as one. See it as a motivator, as a friend, not a foe. Keep it with you and not between you and your goals. “What motivates you?” I’m often asked. It’s diabetes that motivates me to push forward. It’s not a separate entity, it is a part of me and there is so much more to explore with it.

Last turning statement: 

Push yourself; because you can do everything better than what people without diabetes most often don’t even consider doing!

Travel sketches by the author:

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