Ain't No Mountain High EnoughFriday, June 08, 2012
Endurance athlete Sebastien Sasseville was the first Canadian with type 1 diabetes to climb Mount Everest in 2008. He has taken what had been a longtime dream and built upon it a public speaking message of empowerment and confidence in the ability to overcome obstacles.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
During the day the heat of the sun makes the cliff face warm enough that climbers can often shed some of their outer layers of clothing, but the proximity to the sun is so blinding and can harm the eyes and cause headaches. At night, the temperature drops precipitously and when the winds kick up, the sub-zero conditions are thrusted upon your senses with only limited shelter inside your tent. Combine this with the oxygen-depletion your brain suffers at the high altitude, and you experience what climbers refer to as an almost moon-like atmosphere on Mount Everest, the world`s highest mountain.
For the climbers who have attempted Everest, many speak of the mental confusion and overwhelming fatigue associated with the oxygen-depletion. Every step is painstakingly slow, and climbers need several breaths and multiple breaks to keep going, even at a slow, methodical pace up the mountain. They point out that it is not the climb up that causes many to perish, it is the climb down.
This is especially true in what is referred to as the Death Zone—the area that spans from the last base camp, Camp 4, at 8,000 meters (26,000 feet) up to the top of the mountain at 8,848 meters (29,029 feet). This is where Everest has claimed countless lives due to errors in judgment brought on by this confusion and fatigue. And the news of the recent deaths of climbers up on Everest just a few weeks ago is a reminder of the mortal dangers of the mountain.
To get a sense of how much of a physical toll an Everest climb can be on climbers, the Mayo Clinic sent researchers up the mountain this spring to measure what happens to peoples’ bodies as they ascend Everest.
Trying to summit Everest is more akin to an endurance event that lasts over two months. And it does not end at the summit as climbers have to conserve enough oxygen and strength to get down the mountain, according to Sebastien Sasseville. The mountain is not about being measured in terms of its technically difficulty so much, he explains, but the ability to endure living on the mountain in unbearable conditions for so long. (Sasseville is pictured above during his Everest climb.)
Sasseville who is from Montreal, Canada successfully climbed the mountain in May 2008. Not only was he able to summit the mountain, he did so while managing type 1 diabetes. He is the first Canadian with the disease to do so, and he is the third person with the disease overall to have completed this extraordinary achievement.
Sasseville has also completed three Ironmans and is looking to do two more this year. He recently became a part of Team Type 1, which is a group of athletes—some who have diabetes themselves—who try to inspire people around the world with diabetes by competing in various sporting events, including marathons, bike races, and triathlons.
In addition to his busy training schedule, Sasseville also does motivational speaking. He has spoken in front of everyone from young kids with type 1 diabetes to big corporations, delivering his message of empowerment and overcoming obstacles. For Sasseville, having diabetes and climbing Everest and competing in subsequent endurance athletic endeavors has given him a special meaning and focus.
In this first installment of a two part interview, DiabetesCare.net spoke to Sasseville (pictured, lower right) about training for Everest; taking on the mountain with type 1 diabetes; and what life was like in the Death Zone.
DiabetesCare.net: How long have you had diabetes?
Sasseville: I’m 32 and I just celebrated my tenth diabetes anniversary. When I was diagnosed, my brother had been living with diabetes for about five years. It was still a shock, but our family had been through it once.
It didn’t make it easier and you still have to process the diagnosis mentally. You ask yourself a question like, ‘is life going to be terrible?’ However, I made the decision when I was first hospitalized that it would not be something that held me back. I can remember calling my parents to them I had been to the hospital and diagnosed, and they were having a hard time.
I tried to look at it differently, and said to them, ‘I don’t really have a choice. I know that there are drugs and medical devices that can help. Let’s make the best out of it.’
DiabetesCare.net: You came to the acceptance of the disease pretty quickly. What helped you make that leap from the initial acceptance to going forward to say, ‘I’m going to take on Everest’?
Sasseville: I like to think they are separate things. I had been to Nepal [home to Mount Everest] before I was diagnosed, and I had already had a love for traveling, and I wanted to do big things. I did Everest because I wanted to do it, not because of my diabetes.
Still, I would be lying if I said that my endeavors and diabetes didn’t become quickly related, because diabetes gave a purpose to something I wanted to. I am grateful for that, because it has helped give me meaning to some of the things I wanted to do. Through my engagement in the diabetes community and the conferences I have spoken at, to know that my athletic endeavors and overcoming diabetes have been useful to other people makes my diagnosis a gift—and I wouldn’t give it back.
DiabetesCare.net: It sounds like climbing Everest is a long two month process. Can you take us through your climb?
Mount Everest, also known as Chomolungma, (Goddess Mother of the World), to the Tibetians. The white blurs at the top and along the left side of the mountain suggest high winds blowing snow off.
Sasseville: You are not climbing for two months, but everything you do within those two months, are absolutely crucial to your success on the mountain. I flew to Katmandu, Nepal and met up with my team, the Canada West Mountain School. I had been climbing with those guys for several years. It was also a fun moment as it was the realization of a long held dream.
We did gear checks, briefings, and talked about the climbing strategy. We also meet with our support team while in Katmandu.
We then fly to Lukula, which is one of the craziest airports to land at. Your approach into the airport is flying inside a mountain range and you land on a smaller landing strip, which is uphill, and the pilot slams on the brakes at the end of your landing.
Then we took our gear and all our other stuff and hiked to base camp, which took several days.
What makes Everest so difficult overall is that you are up there for such a long time. You have been sleeping on ice, and you have been exposed to a considerable amount of risk, so that stress associated with the risks has taken a huge toll on you. The constant discomfort you are living in, not having the foods you normally eat, and being nauseous from the high altitude—mentally it becomes very difficult. And on the night you begin your final summit bid to the top, you have to generate the most amount of energy to make it to the top and back down to Camp 4.
DiabetesCare.net: What were those preparations to get ready to take on the Everest expedition?
Sasseville: There are three keys you have to be prepared for in climbing the mountain including: the physical, technical, and mental demands. The technical is pretty straight forward you have to get climbing experience. During this training period, I lived in Vancouver, B.C., and I did a lot of local climbs within the mountains nearby. Once a year, I tried to do a bigger climb where I would do something to feel what it was like to climb for a month and to see what I needed to do to prepare for diabetes and the climbing aspects.
I wanted to be away at a remote area for a month and have everything I needed to be self-sustained while I was gone. Through these years, I climbed in Russia, Mount Kilimanjaro in Tanzania, and Cho Oyu in Nepal. Kilimanjaro is a track up the mountain, but it allows you to get a feeling for living in a nearly 6,000 meter altitude range. Cho Oyu is in Nepal, and it is the sixth highest mountain in the world.
During this period, you get to know yourself and get to know your physical and mental exhaustion, especially the latter when everything is going wrong and you have got to keep smiling and keep doing what you need to do to endure the mountain and the environment.
You don’t need to be an Olympic athlete in terms of fitness, but clearly you want to be in good shape and be able to sustain a certain pace for two months.
In terms of the altitude, there is nothing you can do to train for it. However, you do need to educate yourself on high altitude and the things you should do and how to recognize the symptoms of altitude sickness. Everyone gets it, so it is not about avoiding altitude sickness, it is about managing it. Finding that line where on the one side it is discomfort and on the other side things get dangerous. So it is about navigating around that line. Everyone also has a maximum altitude at which they can adapt. And you can’t choose or change that. For example, there are people who cannot go above 5,000 meters.
After five years, I thought I was prepared to make the climb up Everest.
DiabetesCare.net: Understanding you were dealing with a harsh environment on Everest, was there any issues dealing with insulin? Did you have a pump, and how did you deal with your diabetes management?
Sasseville: There is so much work that goes into the diabetes. Everything was fine and fortunately there were no issues, but it was also the result of five years of trial and error. I had taken a lot of notes along the way.
I did wear a pump, and I had another with me for backup. Insulin is also the most labor intensive and stressful part, because if it freezes it’s gone and you cannot use it. You are away from home for three months and you are climbing for two in colder conditions. Insulin is good at room temperature for 30 days, and you have to make sure it doesn’t freeze.
When you use a pump, the insulin comes in small vials. I had three months worth of insulin with me; three months worth I took up to base camp; and another 3 months worth in a refrigerator in Katmandu.
DiabetesCare.net: What are some of the things you learned along the way in terms of insulin and pump strategies?
Sasseville: Since your insulin can freeze, you keep that and you’re blood glucose monitor in the inner layers of your coat. Glucose monitors are all approved for use up to 10,000 feet. These still give you a reading above that, but the higher you go, the less accurate the reading is. Through the years, I did a lot of testing. And questions would come up about how much they were off.
I came to realize it was dangerous to rely on the numbers at such a high altitude, because these measuring tools were not made for that.
You have to train your body and train to learn your diabetes when you can’t rely on the tools you typically rely on. When you have diabetes as an athlete, you want to practice it to the point where you can do it with your eyes closed.
If you are in a competitive race, you don’t have time to test, but your glucose should be in a good range; otherwise, you are not going to perform very well. You want to get to that level where you know exactly how many carbs you want to take in; know exactly what you need to do with your pump; know your basal rates. You go on what I call auto-pilot for the day.
I was forced to do that on Everest because I didn‘t have the measuring tools. If you are competing at sea level it is not a big deal to take a minute to test. Up there, I didn’t have a choice. However, I was grateful to learn to run on auto-pilot.
DiabetesCare.net: Did you find that your blood sugar was normal or a bit off when you were climbing Everest?
Sasseville: I tried to be under good control when I was up there and my number one goal was safety. My A1c didn’t go down when I did the climb, but the range I found to be acceptable was a bit different, depending on the conditions and what I was doing.
When I was camp, I was trying to keep my blood sugars tightly controlled because I knew I needed to recover. If I had a low at base camp, it was easy to treat it; whereas, when I was climbing, I obviously didn’t want to run high say over 200 because it wouldn’t allow me to perform and it would dehydrate me faster.
Higher altitudes dehydrate you very quickly. Plus if your blood sugar is high, you are asking for trouble. For me to be about 150 to 180, which technically is a little too high, up there it was acceptable, because I wanted to be safe and avoid hypos at all costs. That seemed to work.
Since I knew my measurement tools wouldn’t work that high up, I practiced for months prior to the climb to know how my body felt. So, before I tested myself, I would try to guess what my glucose number was. I would ask myself, `what did I eat? What I ate last? How much insulin did I take? What type of carbs? What type of activity?` Doing this has been a huge learning tool to managing my diabetes better. I think before I test.
(Sasseville (right) pictured here next to Brian
Jones (left) from Canada West Mountain School on top of Everest.)
DiabetesCare.net: In your summit photo, you held the JDRF flag up. Did JDRF sponsor you?
Sasseville: I was not sponsored by JDRF. However, I have been a “friend” of the JDRF for a long time. A lot of the projects I have been involved in, I had tried to raise money for diabetes research and JDRF. It was a pleasure to raise the JDRF flag, and the actual flag I took to the top of Everest is in a frame at the Toronto JDRF office.
DiabetesCare.net: What do you recall that day about reaching the summit?
Sasseville: It is emotional but you are also completely exhausted. We were only up there for 5 to 10 minutes. You pull a few flags out, take a few pictures, and that’s it. Once you get up there safely and do those things, you want to get out of there quickly because you know you are in a very harsh environment. You can go from an enjoyable climb to a nightmare very quickly. You never know when you are going to run into technical difficulties with the gear, your oxygen, or the weather.
It’s ironical in that after you summit, you quickly turn around and just head back down, especially after years of preparing and months of climbing the mountain. You start feeling more joyful about it once you get back down in a safe area. In thinking about it after I climbed Everest, I wanted to send the message to other people with type 1 diabetes that anything is possible, and that the disease does not have to be a limitation.
DiabetesCare.net: You are the first Canadian with type 1 diabetes to summit the mountain?
Sasseville: Yes, I think there are three of us in the world with type 1 to have climbed it. The first two happened the same year, 2006. It has been four years since I summited, so I wouldn’t be surprised if more people have done it. The more people with diabetes who do this makes the point even more that everyone with diabetes can do it. This is something that anyone who puts their mind to it, can do it.
This is part one of a two part interview. To find out more about some of Sasseville`s adventures, athletic accomplishments, or to hire him for any speaking engagements, visit his website.