Managing Fear and Getting Lost in the MomentFriday, July 06, 2012
Steve Richert is spending every single day for a year rock climbing as part of his Project 365. This project is aimed at creating a documentary showing the parallels of climbing each day and how it`s similar to the commitment of everyday self-management of type 1 diabetes. In the process, he wants to empower other people with diabetes (PWD) to live their lives more boldly and not be bogged down with the fear-based public messages associated with diabetes.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
There are moments on the rock face where Steve Richert experiences no outside consciousness or awareness. Everything falls away as he works on completing the task at hand—contending with the rock formation he is hanging onto and trying to move vertically up a mountain. During these moments, he is usually several hundred feet straight up where he cannot just call a timeout if he gets tired or his type 1 diabetes begins to act up.
It is within these moments where he is managing the fear of potentially falling, or knowing impending weather like darkened storm clouds are rolling in, or the unsettling feeling of a possible hypoglycemic episode coming on that he "gets lost." Richert has no random thoughts, no outside sensory perceptions—he is just moving through the climb and dealing with the task at hand. As he is in such a heightened state of awareness, he often doesn`t recall portions of his climb after the fact.
This sort of tunnel vision is a mental state that leaves Richert empowered, as he is forced to contend with challenges that eclipse his diabetes.
One such recent example of this was when Richert recently made his first attempt on El Capitan in June. This famous rock formation located in Yosemite National Park in California is composed of granite and is 3,000 feet from the base to its highest point. El Capitan presents a formidable challenge that is considered a crowning achievement for serious climbers.
During his ascent, Richert and his climbing partner, also named Steve, struggled to set up their portaledge, a makeshift camp for them to sleep on, which would be connected to the face of El Capitan. They had to assemble their portaledge by anchoring to the rock formation, while dangling several hundred feet up from the ground and having limited ability to move. They had to create"optional tension" needed to snap their portaledge in place. They tried repeatedly to perform this maneuver but after climbing for several hours throughout the day and feeling exhausted and dehydrated, they were beginning to fatigue and the fear of the alternative was starting to set in: spending the evening dangling in ropes and harnesses.
After a full hour of unsuccessfully trying to set up their camp, the two climbers finally made one last attempt, and they were able to snap the portaledge into place, and get a relatively peaceful night`s rest. Richert details this harrowing experience here in his blog.
Richert believes it is those moments outside peoples` comfort zone that help them grow and create confidence to use fear as a positive motivator through managing risk in the moment. Yet, unfortunately, he believes the dominant public message that is being disseminated today is one that discourages individualism and adventure, and treats diabetes as if it were a disability.
El Capitan in Yosemite National Park
As an alternative, he hopes to deliver messages of empowerment and overcoming fears in his eventual documentary.
DiabetesCare.net spoke to Richert in-between climbs about what life is like several hundred feet up, Project 365, and the importance of empowering people.
DiabetesCare.net: How long have you had diabetes, and how is your overall management and control?
Richert: I have had diabetes for 13 years, and I have generally had good control. I would like to believe it is because I have been very mindful of my diet, and exercised and stayed active. Good control is all about lifestyle.
I`m on insulin injections and all the doctors I have had tried to consistently get me on a pump. I`m old-fashioned, and I like things that are simple. I`m inherently distrustful of electronics. The more responsibility and disease engagement on the part of the individual, the more beneficial it is. Not that pumps are bad. Injections always seemed to work for me, so if ain`t broke don`t try to fix it.
DiabetesCare.net: How did you first get into rock climbing?
Richert: When I was a little kid I was always climbing trees. I was always pretending I was on the side of mountain somewhere. The very first time I was tied into a rope was shortly after I was diagnosed, and it might have something to do with why I went in that direction.
When I was in high school we happened to be doing a physical education unit on rock climbing and it happened shortly after my diagnosis. I had just been in the ICU of a hospital for two weeks. I was in pretty bad shape when I got released, and they told me that I didn`t have to participate in climbing the rock wall, but it was something I had always been interested in, so I tried it and it just clicked for me.
With climbing it felt right. I wasn`t thinking about my diabetes or my sugar or what I couldn`t do. It was very freeing. I felt like I could do anything.
DiabetesCare.net: Can you provide an overview of what your Project 365 is?
Richert: This is a project where I climb for 365 straight days this year. Some of the climbing I will be doing is technical [using ropes] and some will be bouldering, where I`m doing unroped climbing. There are many different types of climbing aside from the generic Mount Everest scenario that most people typically envision.
Climbing has been my passion, and climbing is a nice allegory for facing challenges. It is a universal symbol for challenge. Climbing is physically demanding and is something that relies on suffering gracefully. It is more than physical endurance but also mental endurance.
This is a close parallel to living with diabetes. In a lot of ways living with diabetes inspired this project. I feel like diabetes has been my training ground. I have applied patience to risk management in climbing and in my diabetes management. In addition I have dealt with frustration and learned how to pace myself having the condition.
People complain about having diabetes, and while it can be a burden, if you take ownership of it and flip your perspective around you can make it something amazing.
DiabetesCare.net: Why did you decide to start Project 365?
Richert: I didn`t see anything quite like this. I was driving to my friend`s wedding, and my wife, Stefanie, (the Richerts are pictured on the left here) and I saw a JDRF sign on the road. We got to talking and we realized that there weren`t any major organizations who were promoting a view of PWD that represented me. I figured that there might be some others who felt this way too.
When I looked around, I saw Wilford Brimley or people within the cycling world talking about living with diabetes, but there was very little that represented me.
From the beginning when I was diagnosed, I felt out of step. Rather than be given an inspirational message to encourage me to take care of myself—and even become an unconventional athlete—I was told what I couldn’t do. This was the usual negative representation of diabetes.
A big part of my goal is to help change that for the sake of the public perception of type 1 diabetes as well as improve the way other PWD see themselves. If I had taken that viewpoint from when I was diagnosed, I don`t know where I would be, but I wouldn`t be living my life the way I am. Part of my motivation was to take what Stefanie and I had been doing—living for 3 to 6 months at a time on the road and climbing—and do something that was more parallel to living with diabetes.
The concept to do a year was to find a number that fit in nicely, but also hammer home the idea of consistency. Diabetes is a condition you live with day-in-and-day-out. It really is a lifestyle. It doesn`t go away.
I was reading a news article from a major outlet about type 1 diabetes, and it stated that PWD are at risk of complications and will miss time from work and will have a lower quality of life. I said to Stefanie, `this might be the case for some people, but this is not consistent with what I lived with and my pancreas is just as dysfunctional as anyone else`s with type 1.` The real problem arises when this type of thinking bleeds over into the way PWD see themselves.
I feel like this message of "you are strong and capable" is not being put forward to people. I wanted to present the message that doing something extraordinary takes effort but with repeated effort can be done.
DiabetesCare.net: What is it about rock climbing that you love so much?
Richert: There are different types of climbing and different types of rewards in doing so. One of my favorite things is that it has so many different settings and has taken me to some amazing places that are off the beaten path.
Some climbing is obviously more serious than others but even the most casual types of climbing have some form of risk management. For example, you have to have the harness on and the knot tied correctly even if you are in a climbing gym.
There are some days where I like to climb easier things, and I can just enjoy the movement and the position of where I am. Not all climbing is scary and once you get used to the height it is incredibly enjoyable.
On the other hand, there are situations where you are fearful about falling and solely in the moment. Those situations are much more intense and are a different kind of fun. The key is knowing which type of outing you are looking to have and to prepare accordingly. This happens when you turn fear into focus.
There are moments during serious climbing, where you won`t remember what happened; you don’t really have a chance to think about what’s happening until it is over. It doesn`t sound like fun, but when you are in those situations, and you know that you are prepared, there is a little part of you that looks forward to being tested. And that is what it boils down to for me.
In the top photos, Richert is making his ascent up El Capitan. The bottom image shows the portaledge attached to the side of the mountain several hundred feet up.
DiabetesCare.net: Have you done any technically challenging climbs so far or do you have any coming up?
Richert: Climbing in the desert has its own set of challenges. For example, climbing on sandstone in Zion National Park in Utah is much different because the rock is more fragile. Anytime you are climbing on it, there is a heightened sense of awareness because pieces of the rock can come off. You have to wear a helmet. I have seen refrigerator sized blocks come off with very little provocation. When that happens, time freezes for a few seconds, and you realize that could have had very deadly consequences for you.
In Yosemite, the rock is granite, so that is easier to anchor to, but the length of the routes make it more difficult. The Black Hills of South Dakota and the Fisher Towers in Utah, are probably the scariest places to climb in North America, because the nature of the rock itself it can be very difficult to protect yourself so you have to be prepared for scenarios in which there is zero room for error and you absolutely must not fall.
DiabetesCare.net: It sounds like it is not necessarily the elevation, but the surface you are climbing and technical aspects that make certain rock formations more difficult to climb?
Richert: All climbing is definitely not created equal. There is the Yosemite decimal system which rates the difficulty of the moves on a given climb. The system goes from 5.0 to 5.15. If something has a lower grade, it is not going to be very strenuous. It will have an inward slope and you can comfortably take a hand or a foot off to make the next move, or it is only two or three moves to get a solid rest. You are never without the ability to stop and take a rest, or eat and drink.
Some climbing routes can be hundreds of feet long but if they are classified as a moderate grade they feel a lot easier than climbing 100 feet of a 5.11 or 5.12. There are a lot of factors that determine how difficult a given climb will be, and the total height of the route is only one part of it. The hardest grade route I`ve have done is 5.12, and my goal is to do a 5.13 next.
DiabetesCare.net: With a big climb on one day, will you follow it up with a less technical climb the next day?
Richert: It varies on the difficulty of the climb and usually I go with how I feel. After I completed Moonlight Buttress in Zion—one of my biggest climbs—I felt like I got kicked by a horse. I also became dehydrated because my sugar was really high on that climb. It was a bit of an ordeal. That limited my climbing to easier routes for a few days.
I don`t want to suffer overuse injuries, so there are days I do climbing that is less steep, and I`m not having to do as much with my hands; it is more leg-based than finger-based climbing. This way, I can save my joints a little bit.
DiabetesCare.net: Are there any specific challenges with having diabetes and rock climbing?
Richert: One thing I have noticed is that while I`m on a climb my blood sugar does not usually drop, which of course is a good thing. When your adrenaline is going, and you are excited, your blood sugar has a tendency to stay a little on the elevated side, so hypoglycemia is not usually a problem while I’m climbing. Although it is once you get back down and determine how to bolus for your next meal—that gets tricky.
It is a challenge of always having to be aware of how my blood sugar may be responding even when I am not in a position to whip out my glucose monitor. However, it is different for different people.
For me it is much more psychological, which is what made Moonlight Buttress hard for me. I went into it with my sugar too high. I reduced my basal insulin before going out on the climb because I wanted to make sure my sugar didn`t drop low. And then I increased my basal insulin after I usually do. Being up on Moonlight Buttress was the first time where I had to take a fast-acting insulin during a technical climb.
I have had lows in the past either due to heightened sensitivity or too much insulin, so in having those experiences, it took me a very long time to not worry I would go low on climbs.
I have gotten over those fears off the mountain, but having to manage that on a climb is completely different. You could be 800 feet from the valley floor and 400 feet to go to get to the top, and you know you cannot afford to let something bad happen.
That Moonlight Buttress experience was empowering, but also harrowing. I was getting dehydrated, my sugar was high, and I had to take insulin. It didn`t immediately work, so I had the thought that I should correct again. After thinking it over, I said, `no, I`m going to let it work.`
Fortunately, it worked out for the best. If I had taken more insulin, I would have had a low. The climb was a big deal, but taking insulin in the midst of the climb—that was a bigger deal.
DiabetesCare.net: How are you going about working on the documentary and what are your goals?
Richert: It is a work in progress. It is our plan that we shoot as much as we can and save it all. We went into this project with basically nothing, and we have been able to raise some funding, create a donation page, and a place on the site where people can buy our shirts. The project hasn`t exploded yet. Ideally, we would like to get this story out there and get it picked up, or find a way to get some funding to produce a more professional and full length documentary. Our plan, even if we cannot get a lot of support, is to make a production that we can share with anyone who wants to listen.
Our goal is to use the documentary as an outreach tool for folks who have been newly diagnosed with type 1 and their families. We want to give parents and kids the message, `hey you can do this!` Climbing itself is not really the message as much as the fact that a challenge in front of you is no reason to limit yourself.
We see P365 as a springboard for a bigger project that will mobilize people with T1D to get out and get active. This will, ideally, involve climbing expeditions with T1 climbers (think Team Type 1 with climbing) and facilitating diabetes-adventure activities for T1s of all ages that will emphasize what we can each do by focusing on non-pharmaceutical tools and lifestyle changes. Granted these secondary projects will take a lot more legwork and funding but that is where we see our next step, and that is where we hope this documentary will lead us!
All the photos are courtesy of Richert. To find out more about the project, visit his Living Vertical website here.