I sat in a river raft with my cousin and two buddies, about to take on the Upper Gauley River in West Virgina, the second toughest white water in the United States, and the seventh most ferocious in the world.  The Gauley has five distinct class V rapids, and countless others that will make you feel like you are on a wooden rollercoaster.  The bottom line: if you and your raft mates don’t do your jobs, someone dies.  In fact, 32,001 people have died on the Gauley, and the last death was a 40-year-old Ohio man who died at the first class V rapid half an hour before we arrived there.

Patrick, the river guide, gave us instructions and asked one simple, but important question, “Is there anything I should know about any of you?”  I told Patrick that I’m a type 1 diabetic who wears an insulin pump.  I showed him my waterproof pump case, my blood glucose meter, and all of the quick acting sugar I had in case my blood glucose started to plummet.  Patrick helped me wrap everything into the waterproof bag that I wore at my waist.  I suspended my pump until lunch, which meant I was going to be without insulin for about three hours.  I figured I would rather have high blood sugar than start to shake, sweat, and bottom out with hypoglycemia in the middle of a four-and-half hour river trip.

I’ve always been an adventurous person.  I’ve gambled big in Vegas, gone sky diving, and hiked in Glacier National Park.  But sitting in a raft about to take on the Upper Gauley River I felt a kind of fear I hadn’t felt since I was 14.  I wasn’t just terrified that I’d screw up on the river and never see my wife and kids again.  There was a fear that ran much deeper, not merely the terror of a man about to battle a powerful force of nature, but the fear that I wouldn’t make it because I’m a diabetic.

When I was 14, I was diagnosed with type 1 diabetes.  My first symptoms arrived on the fourth of July. My family and I were at the beach and I was unusually thirsty all day.  When we got home that night, I had no saliva in my mouth, and had to drink water in order to chew food.  In the days that followed I constantly needed to urinate, and often vomited.  My mother thought I had the flu, but it was obviously something more.

Less than two weeks later, I visited my aunt who noticed how much weight I’d lost.  She also noticed that I tried to drink seven different beverages, and nothing could quench my thirst.  She took me to the doctor.  As soon as the doctor saw me he came close and asked me to breathe on him.    “Call 911,” he shouted.  “Tell them we have a fourteen-year-old in D.K.A.”  Then he actually spelled it out, diabetic ketoacidosis.

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Scott (bottom right)

I heard “One forward, boys!”  This is what Patrick yelled when he wanted us to paddle one stroke.  We were staring Insignificant, the first class V rapid, right in the face.  A wave about 6

feet high came crashing down on us.  The river thrashed us around trying to shake us loose from the raft, but we did as Patrick yelled and came through.  Pillow Rock, a rapid filled with undercut rocks that can pull you under and keep you from resurfacing, was next  “Boys, we are gonna start right, head towards the left and let that pillow of water lift us up towards the rock,” Patrick said.  “Then we’re gonna turn, tap our paddles on Pillow, and head through Volkswagen for a clean ride.”   There was no avoiding Volkswagen, a huge bolder sticking straight out of the water, and we rammed right into it.  The force thrust my body forward and I slammed my head into my raft mate’s back.  For a split second I thought we were done for, but Patrick spun the raft in the other direction and we slid off the side of the rock.  We’d been spared.

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My aunt stayed at my side, and when the ambulance arrived at my doctor’s office he told the emergency crew that I was to receive an infusion of saline only.  On the way to the hospital, someone made a mistake, and instead of saline, I received a bag of glucose.   Because of that error, my blood sugar level rose to 1700.  The hospital doctors were unsure how I was still alive.  They rushed me to the intensive care unit, and as I drifted in and out of consciousness, my family received the news that I was not going to make it through the night.  My blood sugar was too high and it had done too much damage to my body. Sooner rather than later, the doctor said, I’d be in a permanent diabetic coma.  I remember my father crying over me and stroking my hair.  I asked him why he was crying and he told me he was just sad and scared. I changed the subject and talked about sports.  Eventually, I was so tired I told him I just wanted to sleep.  And so I did.

At 7:00 am I awoke in my hospital bed to loud beeps and alarms.  I was still in the ICU.  I looked up and saw many doctors surrounding my bed.  One doctor asked me how I was feeling, and I told him, “Better than yesterday!”  He told me I was lucky, that my odds of survival had been about five percent, but since I’d made it this far, my odds were 100 percent, as long as I took care of myself.

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The next two class V’s were Lost Paddle and Iron Ring. I wish I could tell you I was scared but the truth is that since we’d overcome Pillow Rock, I’d begun to feel comfortable and confident.  We launched over Hawaii 5-O, a 20-foot wave, and came crashing down into the river.  I was thrown backwards, but still had a grip on my paddle.  My feet were wedged under the raft seat in front of me and the rest of my body hung just outside the raft.  Immediately I attempted a forward paddle to get my momentum going in the other direction, and it worked beautifully.  All that lay ahead of us before lunch was Sweets Falls, a fourteen-foot drop, which we executed to perfection.

We parked our raft on the river bank and headed to lunch.  I found a dry place to test my blood sugar.  It was 145, a touch above normal, but I thought of it as a tremendous victory.  I’d kept control through the first three hours on the river.  I knew the rest of our trip would be tough and that the river would throw gigantic challenges my way, but I also knew without a shadow of a doubt, that diabetes was not going to hinder me.

I took on the second roughest river in the United States and beat it.  And because of my diabetes, I’ve been taking on an even tougher challenge every day for the last 22 years.  I am winning that challenge too.  I have good days and bad like anyone else.  There are days where my pump functions perfectly and others where it causes problems.  I can count carbs correctly some days and grossly miscalculate on others.  I will have high blood sugar as well as low, but in the end, I know that if I am disciplined, and do everything I should, I will come out ahead.  As I maneuver through life with diabetes, I keep a positive outlook, and when I hit the rough spots, I remind myself of how far I’ve come from my diagnosis, and say to myself, “One forward, boys.”

Scott Richard is a 37-year-old type 1 diabetic.  He lives in Wynnewood, PA with his wife and two children.  Scott is the Director of Trading and Clearing Operations for the NASDAQ OMX Group.  In his spare time he coaches soccer and Little League Baseball, actively exercises, and works on his 77-year-old house.