|First Diabetic to Conquer Everest
Will Cross has taken diabetes to new heights-literally. The Pittsburgh-based expeditioner and former high school principal became the first person with diabetes to reach the top of Mount Everest, with a successful summit on May 31.
Cross doesn't quit; it took two attempts for him to complete his climb to the top. An expedition last year ended just 1,500 feet below the peak, partly because his partner lost vision in one eye from retinal hemorrage and partly because of problems with an oxygen cylinder.
Started Dreaming at an Early Age
Cross remembers staying up all night watching the 1976 Olympics and wondering if it would be possible for him someday to accomplish great things with diabetes.
"I was told very bluntly that I would have to take insulin injections for the rest of my ¡¡fe," says Cross. "That alone was overwhelming, and I didn't even know about the constant juggle with blood glucose testing, diet, exercise and injections."
His interest in expeditioning started with an Outward Bound experience in England when Cross was just 15. "From there I continued to climb and do bigger trips each year," Cross says. "Eventually I applied for a position with Operation Raleigh, but I was denied due to my diabetes. So, I wrote to Prince Charles, who gave me permission to participate." It was that experience that taught the adventurer valuable lessons of being in the wild and managing his diabetes effectively.
Preparing for the Climb
Believe it or not, Cross says, training for the expedition was not as in depth as some people might imagine.
"I do exercise daily-mostly long, slow, distance rowing and biking, the step machine, skiing machine and maybe two days a week of a core weight-lifting routine," he says. "Most of the work starts when you get to the mountain."
Cross usually takes a few weeks to pack for an expedition. When packing diabetes supplies, Cross always brings twice as much as he thinks he will actually need. It's the same with emergency carbohydrates, he says.
"If I think I'll need two PowerBars, VII take four. There are always surprises on the mountain; if the weather changes or a teammate needs help, you get stalled. All of these surprises affect my blood glucose one way or the other."
Packing twice as much as you think you need for diabetes management is the strategy Cross recommends for any travel with diabetes.
"I ¡ay out gear, then look at it and make changes," he says. But even with a great deal of planning, inevitably there's a last-minute rush. "My children and my wife are very helpful throughout the entire process," says the 38-year-old father of six.
Low Blood Glucose on a River of Ice
Cross' most challenging experience with a low blood glucose level at a bad time occurred as the team was crossing the Khumba Ice Fall, a river of ice with ice blocks the size of houses and hotels crashing into each other and even spreading apart and forming crevasses.
"You've got to keep moving through so you don't get crushed," Cross says. "When I go low, I have to keep my wits about me, because as a climber, you don't want to fa¡¡ in a hole. You also want to watch out for what happens to your body and head, which is spinning. Knowing my body helped me get through a rapid low there:"
Cross treated the low at the ice fall by taking in as much carbohydrate in gel form as possible. "I forced myself to go forward and to keep motivated."
Diabetes Management on the Mountain
The Everest expedition tended to be fairly predictable and regular overall, Cross says, in terms of his daily regimen.
"On a climbing day, I'd be up around 4 a.m. and have breakfast after testing inside the tents," Cross says. "I'd use NovoLog insulin pens inside the tent and carry them throughout the day inside my climbing suit so they wouldn't freeze."
The team climbed from 6 a.m. to midafternoon, when Cross would go inside the tent, hydrate by drinking fluids and test his blood glucose. Climbers then tried to get as much sleep as possible before repeating the climbing ritual the next day.
Cross used between 40 and 60 units of insulin each day on the mountain. And, depending on the altitude, he would wear an insulin pump to the base camp or use an insulin pen alone on climbing days.
In addition to adjusting his insulin delivery method based on altitude, his climbing schedule also required changes in diet to increase protein intake.
"Altitude tends to eat your muscle faster," he says. Fiber and protein, plus sport nutrition bars and energy gels, are an easy way to get needed fuels. 'I'd also try to drink plenty of water."
The climbers' diet consisted of regular foods that included a lot of rice, curries, biscuits and chicken. The altitude had significant effects on Cross' body, he said.
"I need more hydration than most climbers, because I'm trying to flush out any excess blood glucose. I eat a lot of energy bars to keep my blood glucose where I want it. My body reacts to altitude as if it is sick, so it goes into overdrive. My blood glucose tends to run high, and that's where the insulin pen is very helpful:'
In the two weeks it took to get to the base camp, Cross spent time doing as much blood glucose testing and monitoring of his diabetes as possible with about six tests daily.
"This helped me get a picture of how my blood glucose would react as I climbed higher and higher on the mountain," he says. After the start of the trip, I test about four times daily.
Cross credits modern advances in diabetes management tools, such as predictable types of insulins, insulin pens and pumps, which enable him to participate in expeditions that would have.
The First With Diabetes to the Top
It was that kind of focus and perseverance that helped Cross reach the summit of Everest, becoming the first diabetic to stand on "the top of the world."
I was surprised to reach the summit," Cross says. "I was so focused on every two feet in front of me, that when I got to the summit, I was surprised to be there. I felt good and strong.”
The climb felt best when he returned to the base of the mountain, he says. "I can't let my guard down until I finally get to base camp and take my gear off. That's when joy seeps in. It's tremendous satisfaction long after you've finally reached where you wanted to go."
As far as future expeditions go, Cross says he would like to go to Russia as well as Greenland and South Georgia Island. "I'd also like to go to the North Pole from Canada."
Living his dreams is a matter of following good diabetes management-and it can be that way for others with diabetes as well, the adventurer says. "Diabetes doesn't have to stop you from pursuing what you want to do. You can lead a full, rewarding ¡¡fe if you carefully manage the disease. People should pursue their dreams," he says. "It's really that simple."
Watching for low blood glucose levels
Cross says his body's sensitivity to low blood glucose levels is key.
"My body senses very quickly when my blood glucose is dropping,' he says. "I address it quickly so I don't lose that sensitivity."
Keeping "honey stingers," energy gels and other fast-acting carbohydrates in easy reach allows Cross to correct any hypoglycemia by moving more slowly than the rest of the team without dropping out of the climb.
Cross manages his blood glucose levels with the specific aim of maintaining his ability to feel fluctuations.
"I keep my hemoglobin A1C in the high 6s to low 7s," he says. "The risk to me of keeping them lower is losing my sensitivity to the lows. I've got to know when I'm going low and when I'm going high. I'm certainly not recommending people do this, but it's what allows me to do these kinds of expeditions. Been impossible years ago for a person with diabetes."
|Managing his type 1 since he was 9 years olp helped Will Cross to develop the "can outlook and perseverance he needed to' climb. In addition to Mt. Everest, Cross has climbed:
|• Mt. Blanc
• El Matterhorrn
|• Grand Teton
He has also participated in expeditions to Patagonia, Mountains of the Moon, the Sahara Desert and Indias’s Thar Desert. These adventures are part of his larger goal (called the “NovoLog Peaks and Poles challenge"): to become the first person with diabetes and the first American with or without diabetes to reach the tallest peaks on each of the seven continents and trek to the North and South Poles. He has already claimed the title of the first Diabetic to reach the South Pole.