Summiting Everest with Diabetes: An interview with Sebastien Sasseville (Days 1 and 2 at CWD FFL)

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Sebastien Sasseville's diagnosis of Type 1 Diabetes in 2002 did not cause him to rethink his goals as a mountaineer. Having trekked through Nepal in 2001, Seb already had his sights set on climbing Mount Everest, the world's tallest peak. He did in fact reach the summit in May of 2008, sending a powerful message that we can all climb our mountains - whether they are in the form of an illness or literally thousands of feet tall.

After meeting Sebastien and listening to him give a presentation about his experience climbing Everest, I was completely awed. Not only does he set an incredible example for people with diabetes, in terms of managing the disease and not letting it slow him down physically, he inspires everyone with his attitude.

Two quotes from Seb:

"Diabetes felt like a gift from Day One. I can't honestly say why I felt that, but I did.""Diabetes and Everest - two obstacles. One I chose and one I did not. I wouldn't have climbed [Everest] without having diabetes."

It seems to me that Sebastien has been propelled forward by his diabetes rather than been held back by it at all. He really values the challenge that has come to him in the form of diabetes, and perhaps this is what has made him embrace other challenges, such as climbing Mount Everest.

I was lucky enough to speak to him one-on-one about what is was like to test his bg, take insulin and stay sane while up on the mountain. Here's how it went:

When you were first diagnosed, did you think that you might not be able to achieve your athletic goals?

No - Obviously, the first few months, you take it easy... you have to learn how to eat... [how to just adjust to diabetes]. I stopped and started progressively to get back into [training]. Then the next thing was, I wanted to share with people my love of mountaineering, and my vision that diabetes wasn't a limitation, so I organized a trip and we took teens to Mt. Kilamanjaro. That was in 2005. It took about a year just to put the project together, and then a year later, we had the first information sessions with the parents and the families.

How many teens did you take?

We had nine teens with diabetes, although about a hundred families had showed up at the information sessions.

Did any of them have mountaineering experience?

No, nothing. Absolutely nothing. Kilamanjaro is not a technical [climb] - it's just basically a long trek. You are going into very serious altitude, you're almost touching 6000 meters, so there are some risks, and every year people die on Kilamanjaro - it shouldn't happen, you know?

So, I did that, and then continued training at home. I lived in Vancouver, so I took mountaineering lessons, and I climbed - every year I tried to climb internationally, and climb something bigger, to kind of test my body at altitude. Not everybody can take altitude; some people just stop acclimatizing at 5000 or 7000, it's just a personal thing, so you want to test that before.

Then in 2007, I took another group of teens with me and we went to Mount Everest Base Camp, it was the second time there for me, and it was just awesome... just so moving and rewarding for me to take people there, because that's where everything had started [for me]. And I knew I [would be] going back a third time, a year later, and it was just so neat to share that with the kids and people with diabetes.

Kept training, went back to Tibet, trained there, climbed, came back home, kept training, and then in March 2008, we left for Nepal.

Wow So that's when you went for it. Now, I can't even imagine how you carried all your diabetes supplies with you on the mountain. So how does that work? Didn't your insulin freeze?

Yeah, the logistics... well, insulin's one thing. Imagine packing all your diabetes stuff for a week, and it's easy to forget something, you know, just for a week, you bring a lot! You bring what you need, you bring backups... so, try to imagine if you have to leave for three months. So, you've gotta leave for three months, and during those three months there's going to be no way to get something you forgot, and go to the pharmacy. You leave with a huge bag of supplies, and a strategy - a plan - and that's it. So, you need to get really good to figure out what that plan is. I left with two pumps, insulin pens, about a year's worth of insulin - always had a lot, 2-3 months worth with me, 2-3 months worth at base camp, had 2-3 months worth of insulin in the city, you know, that was my worst-case-scenario. Same thing with [other] supplies, test strips... I left with about 15 monitors, 5 sets of glucagon, needles, everything... so, a huge bag! And it's not only about having enough, it's the transportation and storage of all these supplies and drugs. It doesn't matter how much insulin you have, if it's all in the same place, and if that freezes - then, who cares if you've got 5 litres, haha, right? So you need insulin in different places, so it's a lot, a lot, of planning... and it took a lot of years, to get good enough so that I left home and felt very confident that the plan I had was gonna work, and it did work.

Did things ever not go according to plan?

Yeah... nothing major. I froze some insulin in Tibet once, and it was not a big issue, because I had a ton more, but it was so frustrating, right, because it was 100% human error. You know, I had just forgot my insulin outside, so...

The people you had climbing with you - how much support did they give? How much did you rely on them to watch out for you in terms of diabetes management?

They did, and if they would not have felt comfortable with it I don't think they would have wanted to climb with me. We gave them basic training on diabetes - what to do, what not to do - but basically, I never would have wanted things to get to the point where I needed help. Because the only, I mean, they would only have to do something if I was unconscious due to diabetes - and you don't wanna get there! And because we had climbed before on smaller mountains and they [had] seen me over the years deal with diabetes and they knew it was not an issue. It's something that you owe to your team, right - you don't want to be a burden. So, for a number of years, they saw me healthy, saw me taking good care of it, they saw me not going low all the time on climbs.... So the image that I showed them of diabetes was never something that was going to hold me back, or hold the team back, or bring extra risks, so that's why I think they felt comfortable.

When you were up on the mountain, how often did you test your blood sugar?

It depends. The monitors - any monitors, not only OneTouch, but Roche, Contour- all the monitors are only approved to go up to 10,000 feet. There's a lot of things that happen, both in the monitor and in your blood, that makes testing not accurate above 10,000 feet. Base Camp is at 17,000 feet - that's where you start.

So what do you do?!

You still test, and at lower altitudes, when it's possible. I did a lot of testing with the control solution, to see that the monitor was working properly. And then you adapt to the inaccuracy of the monitors - not because [the monitors] are not good, it's just because they're not designed to [work at high altitude].What I would do was never base an insulin decision on only one test. I would test, like, three times in a row, and if I would get a 120, 160, and a 200, which is totally possible at high altitude, that's how much it will swing, then depending on the situation, I use the average, or the lowest value. If I'm climbing and don't want to go low and If I know it's gonna be more complicated to treat a hypo, then I'll take the lowest possible dose. If I'm in the tent at night, surrounded by food, and would rather be a little lower, have my blood glucose be closer to normal, then I would go with the average or even try to make myself a little lower, so I at least knew where I was. The other thing, too, is, up on Everest, the goal is not to lower my A1C.  The goal was not optimum control. All I was worried about was safety. And having blood glucose that would allow me to perform. And I wanted to avoid hypos at all costs. Starting a climb at 100, that's not high enough, there isn't enough of a cushion. I tried to keep myself around 150-160 to 220... again, not optimal, but it's just safer.

Absolutely. What advice do you have for other kids with diabetes?

Everything's possible. Even if their dream sounds complicated, or even if it's never been done before - you know, I'm a big fan of trying new things, and proving that things can be done... First, you believe in the dream, then to be creative, and that starts often with educating yourself, and then you plan your path, plan for every possible scenario. And then you [have] experiences. And you take notes. And you make it work. You know, it's not because you [went] low, it's not because your testing strategy didn't work, that you failed - you just learned something. You learned what didn't work, and youre not going to do it again. And you go back to the drawing board and come up with a better strategy, and then over the years you get to the point where the big day comes, and you go for a dream, and have a system that works.

Did people ever doubt you or think you were crazy?

Yeah, people worry. It's okay. That's normal. I think most people understood what I wanted to do, and that it was more than just about climbing, and it was about the message I wanted to send - and that, people are very supportive of. Again, it's your responsibility to prove to people around you that you can do it safely; people around me always saw me out being well-controlled, and so didn't worry as much - they knew I was ambitious, but they knew I wasn't stupid and, you know, didn't want to go kill myself. So I worked really hard to develop the expertise to get to that place.