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Re: [IP] Question re pumping while on a white water raft trip


I went white water rafting one month ago with my pump (Disetronic 
H-TRONplus V100). I spent about 5 hours on the Black River in Watertown, 
NY. Water levels were high (approximately 9800 CFM, if I recall), rapids 
were class 4 & 5. These trips here don't run in water any bigger than this.

I left my pump on for the entire trip - I never disconnect for exercise. I 
did place the red "tappet" on the top of the pump, since rapids can also 
move a lot of silt - I didn't want to get gritty / silty water in my pump's 
insulin cartridge chamber. I wore the pump on the inside of the waist belt 
on my shorts, to avoid contact with stuff - bailing bucket, paddles, life 
jackets, people, etc. This worked fine.

The trip was rough, as expected. I was in the bow of the raft, so I got 
banged around a lot - a whole lot :-) My life jacket did provide a good 
deal of protection for my pump, since the jacket came to my waist level, 
and was strapped on *TIGHT*. I had my "exercise" BG meter (Precision QID) 
and numerous tubes of glucose tabs in plastic bags, inside a zip pocket in 
my shorts. I tested my BG at every stop and between sections of rapids.

Water temperature was quite warm, probably around 68 degrees. Wet suits 
were not required, and there was no real body heat loss to the water. 
Outside air temps were around 85 degrees. It was very comfortable.

I wore a Tender infusion set for the trip, but had to change at the end of 
the day - it just got beat up too much.

Specifics will vary, depending on the guides, but they generally spend a 
good amount of time before the trip detailing what to expect, asking you to 
sign a waiver, etc. Our guide asked us if anyone wanted to let her know of 
personal medical information - *TAKE THE OPPORTUNITY TO SHARE MEDICAL INFO 
WITH THE GUIDE - IT'S VERY IMPORTANT*. It's also important for others you 
raft with to know of your diabetes.

Since I'm used to exercise with my pump, I reduced my basal rates 70 % - 90 
% during the trip, based on my experience with strenuous activity. My BGs 
were in a comfortable range 120 - 150, but a bit on the low side when we 
stopped for a break (79) after some major paddling work. I overcompensated 
for the "low", and coupled with the fact that my Tender was being beaten 
up, I ended the trip with a BG of about 225. A new infusion set and bolus 
fixed things up. There were drinks and snacks at one of the break areas, 
but this will vary, depending on the organizers of the trip.

It's impossible to offer specific suggestions on how much of a basal rate 
reduction your husband should set, or whether he should disconnect 
entirely, relying on shots for the duration of the trip. This where the 
expression "YMMV - Your Mileage May Vary" really comes into play. The only 
"rules of thumb" I use is:

1)  If I'm unsure how vigorous / extended the activity will be, I'll reduce 
my basals *way* down. It's then easier for me to bolus to bring down an 
unexpected high BG during exercise, rather than constantly battle with low 
BG. This has worked well for me - I've had few incidents of lower than 
desired BGs while exercising.

2)  Plan for the unexpected - I had my "other" insulin pump in my vehicle, 
in case I totally lost mine. I had insulin in a cooler, and a couple 
syringes, warm dry clothing, etc. We had spare keys stashed in the area we 
parked our vehicles, etc.

3)  When I'm really uncertain about something, I check with my health care 
team. Sometimes we work out creative solutions.

Bob Burnett
mailto:email @ redacted

At 10:56 AM 9/11/2000 -0400, you wrote:
>Could someone please give my husband some advice?  He is new to the pump and
>will be going white water rafting on the Deep Gorge River in Fayetteville,
>WV next Saturday and had some questions.  He was wondering, because of all
>the exercise he will be getting, would it be better to take the pump out of
>him to avoid going to low and using shots for the duration of the trip
>(about 6 hours)????  Or, what would be a good basal rate for extended
>periods of exercise?  Does anyone have any experience in this?  He is about
>5'11" and 230 pounds, very muscular.  I'm not sure what his current basal
>and bolus rate is.
>How should he adjust the pump?  Any one have a good formula?  Or any
>experience in this?  I would love to hear from you with any suggestions/
>email @ redacted

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