Meet Will Cross: Explorer and Mountaineer with Type 1 Diabetes
In May 2006, Will Cross became the first American with Type 1 diabetes to reach the summit of Mount Everest, the highest point on earth. This alone is an amazing feat, but for Cross it was the capstone of a much greater achievement: successfully summiting Everest made him the first diabetic in the world, and the first American ever, to have climbed the tallest mountains on each of the seven continents and walked to both the North and South Poles. Cross's multi-year campaign of scaling these peaks and trekking to the farthest corners of the globe was sponsored by Novo Nordisk (producer of Novolog insulin), thus the combination of all these adventures is called the Novolog Peaks and Poles Challenge.
During the Peaks and Poles Challenge, Cross encountered some of the most dangerous and inhospitable environments known to man, and his diabetes was another risky factor. Balancing insulin, food and exercise can be difficult for most of us in the comfort of our own homes. Maintaining that delicate balance amidst sub-zero temperatures and high winds while expending tremendous amounts of energy and dealing with oxygen deprivation - well, that takes diabetes management to a whole other level We may have already heard about doing blood sugar checks and administering insulin at the top of the world (see my post from last year about Sebastien Sasseville, the first Canadian with diabetes to summit Everest), but that didn't stop me from asking Cross about it in detail, among many other things! What I found is that the logistics of being an explorer with diabetes are interesting, sure, but the heart of this story lies in Cross's mentality and motivation - the why, not the how. Cross's story should resonate with all of us - it's about going after what you want.
At the age of 9, Cross found out he had diabetes. He also found out that his dream of becoming a military pilot like his father was no longer possible. This was devastating, but it has since become the only instance in which diabetes kept Cross away from something. He swam competitively throughout high school and college - notable because even today, some young adults with Type 1 are discouraged from competing in sports.
Cross grew up in England. At age 17, he found out about "Operation Raleigh" (named for Sir Walter Raleigh) - a three month excursion for teenagers that would involve science, service, and adventure. Some would call this the opportunity of a lifetime.
Cross says that "[With Operation Raleigh] I had the opportunity to go to Patagonia, and when I got the expedition application, I was a junior in high school, and I already knew by then that I wanted to take a year off after high school, and the application said that 'if you have epilepsy or diabetes, we cannot even consider you for the expedition because of its rigorous nature.' As a competitive athlete, I was infuriated. The only other time I had ever run into a problem was when I went to get my driver's license and I couldn't get it [at first] because I didn't have a doctor's note."
With some encouragement from his family, Cross got himself a spot on Operation Raleigh anyway.
"I had been taught early on that I really only had two choices with this thing - one was to whine about it and one was to do something about it. My mother suggested, 'Why don't you just write a letter to the head of the expedition?' And I said, 'Mom, that's Prince Charles!' And she said, 'Yeah, he gets letters all the time,' which is true. So, I sat down with my grandfather and we wrote a letter and I pleaded my case, and I got a letter back from Prince Charles saying that I pleaded a good case and I would be given the chance to go on the expedition."
After getting the go-ahead from the Prince, Cross again sat down with his grandfather to write more letters - this time asking for funding for his upcoming adventure.
He says, "I got sponsorships from blood testing companies and Kodak and I got my airline ticket paid for - I got the whole expedition paid for - that's really when I began and learned the process of getting sponsorships."
Although he had support from his family and from these companies, Cross didn't receive much endorsement from medical professionals. "Once I knew more about the expedition and the range of temperatures and the difficulty of rescue, the doctors point-blank said 'we really can't advise this' and of course that's their obligation, that's patient care," he says, adding that "there was no direction in terms of diet, protein, fat... bolus rates, basal rates - nothing."
Operation Raleigh was just the first of many adventures Cross would embark on. Once he was out of college and had spent some time climbing and hitchhiking around Africa, he knew he wanted to keep climbing and exploring.
And he did. He says that the "turning point," though, was this desire to walk to the South Pole. Growing up in England, Cross had repeatedly heard the story of Captain Robert Scott "conquering" the South Pole "and how noble that was - even though he died on the way home - [and] that this was a grand expedition and really the way to do something and be somebody."
He says, "I thought going to the South Pole was sort of a romantic endeavor, and would be an exciting and difficult trip. I had no clue what I was getting into. I just knew that I wanted to do it, and try it - I had no idea if I could succeed. And I was naÃ¯ve - I didn't realize at the time that diabetes would be the major stumbling block."
Until that point, Cross had been living his life without hearing - or choosing to listen to - people say "you really can't do this because of your health." Yet that's exactly what he ran into when he asked corporations for large amounts of money for the South Pole expedition. "They were concerned about frostbite, nerve damage, that I would go blind because of the holes in the ozone layer; they were worried that I'd get a heart attack because of the high fat diet; they were worried that I couldn't last pulling a sled for 60 days straight."
Obviously, Cross made it work. "But," he says, "I think it's important to realize that I had no idea [what I was getting into]... the only thing I really knew was that I did not want to be stopped because of my health, and that was a matter of just being stubborn I guess. Driven."
Dispelling the myths that people had about the safety of a person with diabetes trekking to the South Pole eventually became the focus of the expedition. Originally, Cross had wanted to make the trek to fulfill a personal quest for adventure and glory, but it soon turned into something bigger. When Cross was having trouble securing the funds for this expedition, he told his team, "I don't know if I can pull this off." They told him that he was "missing the most obvious thing," that his niche was the fact that he had diabetes.
"So 'make the best of your perceived weakness' was really the strategy," Cross says. "It [became] a scientific expedition where I set out to answer all those questions that corporations had asked me, but we had no evidence to say that they were wrong in their perception. So we said, let's study that, and what we did is we basically compared my physiology to my partner's, who did not have diabetes but his father had died of complications. So the theme of the whole trip became diabetes. And we wanted to answer all those questions... The same questions that parents run into - they're told that their kids can't play in away games, that they can't do overnights, that they shouldn't be invited to birthday parties... the same thing that teenagers run into in relationships - 'do I tell him or her that I have this condition?'... and the same thing [with] young adults - you know, 'do I tell my employer that I have this condition?'. I wanted to take those questions head on, because my experience was that, you know, I could do it. You didn't deny the fact that I had diabetes, but everybody's got something; I just happened to have diabetes."
To prevent his insulin from freezing on his expeditions, Cross enlisted a student from the Art Institute of Pittsburgh to design a pouch made from special material that Cross got from NASA. According to Cross, it's the same material used to insulate the engines of the mars lander and protect them from freezing in temperatures as cold as negative 100 degrees.
Apart from that piece of technology, Cross has to rely on very basic equipment for most of his diabetes management out in the field. "I can only, on any of these expeditions, test blood sugars inside the warmth and the safety of the tent. The safety because I'm protected, I'm not gonna fall or anything like that; the warmth just because that's what required for the machine to work and for my blood to flow. When I'm climbing or when I'm walking to the pole during the day, 6-8hrs of exercise, I can use pee sticks. And it's not 100% accurate, but it's one piece of information that tells me how I'm doing. "
Cross is also very good at guessing his blood sugars based on feeling. He says that's an advantage of being diagnosed in the "middle ages" of diabetes, "when you only knew what your blood sugar was through urine tests... Being in tune with my body was a requirement."
On a related note, here's a link to my first Diabeteens post ever, in which I say "at least we're not peeing on strips anymore!"
He adds, "I've had to figure out how to bolus and basal at altitude through experience... I initially thought that as I climbed higher and worked harder that I would need less insulin, and that was wrong. What I found out was that you actually need more because your bodys under more stress, just like a sick day. No doctor would know that - it makes sense now that I say it, but until we had done it - that's the value of the research and the science."
By pushing the limits of what is possible for people with diabetes to do, Cross is certainly making things easier for young people with diabetes who might otherwise be hesitant to go after their dreams. Personally, there have been times when I was afraid to do something because I worried that it was just to hard to do with diabetes.
Cross says "there's nothing wrong with being afraid. That keeps you wise, that keeps you humble. If you're not afraid you're sort of flying blindly, you're arrogant - a healthy dose of fear will keep you alive. But my advice is always to think about what you really, really want, I mean, deep down inside, what do you want to be, what do you want to become, when you go to bed at night and when you wake up in the morning. I don't think it's complicated. What's complicated is getting there and keeping things in balance. But I think everybody wants something. You just have to decide what that is, and then you go out and do it to the very best of your ability."
Up next for Cross? Something called the Giant Mountain Challenge, which entails climbing 6 peaks above 26,000 feet. He's already completed three of them, so he has three to go. "The idea," he says, "is to continue to show parents and people living with diabetes that it is possible to get out there and do extraordinary things, while still recognizing that this a serious condition, you know, it's a global epidemic now.. there's more diabetes, it's more and more expensive... but, you know, that it's possible to do those things."