A Pilgrimage to Peace With Diabetes

Each year, one hundred thousand peregrinos, or pilgrims, set out forSantiago De Compostela in northwestern Spain to visit the bones ofSt. James buried beneath the cathedral. Called El Camino deSantiago, it's one of the world's largest Christian pilgrimages.

Twenty years old and flat broke, I had an itch to see the world fromthe seat of my bicycle. When I learned that the pilgrimage could bedone on a bike, I was hooked.

If I had seriously considered the enormous challenges of the trip, Iprobably would have cancelled my plane reservation. Instead, Ibought a travel insurance policy and dove into a mad rush of fillingprescriptions, ordering and purchasing supplies, tuning my bike,reassuring my parents, and convincing a friend to come along.

At the time, I was on multiple daily injections of Humalog andLantus, and there was not enough room in my bicycle packs for allthe syringes I would need. My doctor advised me to take two insulinpens instead of syringes because the needles and vials for a pen aremuch smaller.

To keep the insulin cool I bought a product called Frio, acrystal-filled pouch that comes in several sizes. When submergedfor five minutes in cold water, its crystals turn to gel and keepthe pouch at an insulin-friendly temperature.

I packed twice as many supplies as I expected to need, as well astwo blood sugar meters, a glucagon kit, and extra prescriptions formy medicines. I obtained a doctor's letter for customs, airportsecurity, and anyone else who might be alarmed by all those needles.In no time at all, my friend and I had boarded our plane and were onour way to Spain.

Diabetes makes adjusting to new time zones especially difficult, sowe spent three days in Barcelona recovering from jet lag beforedriving to Pamplona. There we ambled down cobblestone streets to thechurch where we applied for our credencial del peregrino, a documentproving our status as pilgrims. Smiling at my garbled Spanish, thepriest questioned us about our intentions, then handed us ourpilgrim's passports and wished us well. We were off.

For just one or two euro a night, we stayed in churches, abandonedschools, and converted homes, all official albergues and refugiosprovided for the pilgrims by the Catholic Church. I slept on thefloor or on a thin pad, face to face or face to foot with otherexhausted and malodorous wanderers. Each morning we rose at dawn,ate a breakfast of bread and café con leche, and bought foodand water for the day's ride.

My insulin needs dropped dramatically, and I had to eat and check myblood sugar constantly while riding. No matter how isolated thecountryside, there was always at least one gas station along the waywhere I could restock my portable pantry and bottles of water andjuice.

Through trial and error, I eventually determined the correctdose of Lantus and found that I had to give myself boluses ofHumalog only for large meals eaten while resting. Heaps of pasta,paella, and tapas at the end of the day gave me energy for thefifty- to-ninety-mile-ride I faced each morning.

Out on the open road I sank into a steady rhythm, talking myselfthrough brutal moments of fatigue. It's one thing to climb a fifteenpercent grade with nothing on your bike, but it's another thingentirely to do it with forty pounds of gear. My leg muscles morphedinto iron fists. When I was not dazzled by the scenery or coachingmyself to push harder, I thought about the past and tried to figureout what had motivated me to take this pilgrimage.

I was diagnosed with type 1 diabetes when I was twelve years old. Itwas my introduction to the randomness and unfairness of life. Oneday I was an avid soccer player and one of the fastest runners in myschool, and the next I was on a strict meal plan and couldn't eatsweets. Everything that went into my mouth had to be measured andits carbohydrates calculated. Suddenly my world shrank, my freedomdisappeared, and an early fog of adulthood crept in.

When people asked about my condition, I chose my words verycarefully. I was not diabetic; instead, I had diabetes. Thedistinction was important because I did not want to be identified bythe one part of myself that was sick. I distanced myself from theillness as much as I could.

Begrudgingly, I went through the motions of checking my sugar levelsand giving myself injections, but my heart wasn't in it. The onlyway that I could deal with such an overwhelming challenge was topretend that it didn't exist. If I let myself think about the riskof complications, I cried and felt sorry for myself. My own body hadbetrayed me, and I could not forgive it. Why should I take care ofit? After all, what had my body ever done for me?

One of the most challenging passages of El Camino is betweenPonferrada and O'Cebreiro, a medieval stone village on top of amountain. During that ascent, the reality of my refusal to facediabetes finally hit home. The hill ceased to be merely a hill andbecame a metaphor for the challenge of living with an imperfect andtreacherous body. My legs throbbed, but I would not quit. To getoff my bike would be to admit that I was fundamentally weak. Theimportant thing was to not give up.

While climbing that endless hill, I realized that after my diagnosisof diabetes, I quit. I gave up on my adventurous dreams andfantasies. I gave up on the idea of being healthy and living a longlife, and I gave up on ever having good control of my disease. Tearsflew from my eyes and down my cheeks and I began to talk aloud,encouraging myself to continue, assuring myself that I could do it.

I demanded that I prove my strength. Finally, in utter exhaustion,I fell off my bike and lay by the side of the road. I had notreached the summit, but I had given it every atom of muscle andwillpower that I possessed. I was unashamedly proud as I sat by theside of that road smiling to myself. If my legs had not been jelly,I would have danced a victory jig. Instead, I dragged myself backonto my bike and tackled the remaining few miles.

When my friend and I at last arrived in Santiago with thousands ofother pilgrims, I rested my bike in the shadow of the greatcathedral and let the tears fill my eyes again. My pilgrimage hadre-ignited a part of myself that my diagnosis had extinguished. Ithad been a journey to recover my lost faith in myself, a pilgrimageto my own strength and resilience. My wholehearted, whole-body,whole-mind effort had restored the health of my spirit.

By the end of El Camino de Santiago, I'd shown myself that I couldstill rely on my body. I was stronger and healthier than most peoplewithout a chronic illness. I'd climbed mountains and fallen from mybike in exhaustion rather than give up. The pilgrimage was indeedun camino, a path or way, that led to a new understanding of mydiabetes and myself. There will always be challenges to thisdisease, but I learned along El Camino that I am stronger than Ithink and I can trust myself. Buen Camino, as the pilgrims say. Good Journey.

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