Early sunrise as we departed from Negreira

Early sunrise as we departed from Negreira

Jeanie preserving her supply of insulin by taking insulin back out of a dysfunctional pod

Jeanie preserving her supply of insulin by taking insulin back out of a dysfunctional pod

We left Santiago with three more days of hiking mapped out to make it to the coast. All went smoothly on our first day to Negreira, but our second day unraveled a bit to leave us in a crunch.

Jeanie had started the morning low, but was trying to hold out for coffee and a real breakfast item before resorting to morning Oreos. But when no coffee shop was awake, and we were flashlighting our way through the woods with Jeanie persisting low, we decided a real stop was in order.

We plopped on the side of the trail and watched the morning crowd pass us by as Jeanie dug out a few rice cakes and slices of cheese, mentally telling herself to let her levels recover instead of racing ahead. After some chatting with other pilgrims, we reorganized our packs, strapped them on, and started walking. A mere ten seconds later, a steady alarm sound went off. Jeanie turned and looked at me, clearly ready to chuck all diabetes equipment into the sea, if there had been one available.

“My pod!” Her frustration was more than warranted, as we have been dealing with malfunctioning and questionable pods for the last week and a half now. With the pods going out early, we had recently checked to see if we were even going to have enough to make it through the end of the trip. Jeanie re-tallied again to make sure. Yes, thanks to packing nearly double what she had anticipating needing, we would have enough.

“But Jeanie, what about the insulin?” I asked. She had packed a generous amount of insulin, but had been filling every replacement pod with a full amount, which was then lost when discarding the pod. She may have had enough to fill the pod at present, but if she had to keep filling faulty pods, it crossed my mind we might soon be out! She looked at me, a look of concern on her face. She went through her insulin supply. “You’re right,” she said “I am going to have to switch to shots.” At this point we took our packs off and started taking inventory.

We went through her supply of long and short acting insulin, pods, and syringes and tried to find her paper of instructions detailing how to switch to a manual shot system if her pump malfunctioned. She could not find the paper, and was hoping she hadn’t accidentally put in the pack she had sent home earlier in the trip.

I had a copy in my bag, which I pulled out and took pictures of with both our phones. If you are traveling with diabetes, it can be very helpful to have a buddy carrying copies of all necessary medical documents! Jeanie later found her paper, but the copy was able to help us out when we needed it the first few days. During those days when we had one copy, the pictures on the phone were a way to immediately “copy” the paper again, so that we would never be limited to one source. Having the image on the phone also keeps it readily accessible, and in a format where it is easy to send to someone if that becomes necessary as a reference for doctors you are interacting with at home or abroad.

We would need more insulin, but due to not filling the last pod, we would have enough to get through a day or two. “Can you take insulin back out of a pod?” I asked Jeanie out of curiosity, realizing we still had the malfunctioned pod which she had inserted full of insulin only a day prior. “I never have, but I think you can!” She said, looking surprised. “Let’s think how to do this” . . . She took a syringe out of her bag and poked through the insertion hole of the pod she had just removed, slowly she drew back the plunger and the clear insulin began filling the syringe! Yes! Our supply had just increased. Jeanie did not put the withdrawn insulin into her existing vial, so that she would not risk contaminating the only available insulin she had. We had no empty vial, so Jeanie put the cap back on the syringe and we thought through the most secure way we could store it. She came up with the genius idea of using the hard cardboard tube which we had received to store our pilgrim’s certificate form. She dropped in the syringe and we started repacking our strewn about items.

As we walked we talked through different scenarios and action plans and, within 30 minutes, Jeanie made the decision that it was not smart to continue. When all factors were considered, Jeanie was using a manual shot system which she hadn’t used in years, with a different type of insulin than she had used in years, and we were on a very low populated trail, in the woods, with few towns, possibly without pharmacies, and we were looking at a few strenuous 20+ mile days. Remember when I talked about the fine line between adventure and foolishness? Well, we were crossing it. We decided it would be the smartest decision to go back to Negreira and try to find insulin.

The only issue was that we were in the middle of the woods, didn’t have a map for this section of the trail, and only knew what everyone had told us, that there weren’t many towns along the way. We teeter tottered between going further and going back . . . we moved forward. Check in with us soon to hear how our insulin hunt continued!