High cholesterol meets ketosis: an update

A couple of years ago I started using the ketogenic diet to manage my blood sugar as a type 1 diabetic and to enhance my athletic performance. I wrote a series of blogs and an ebook to share that experiment because adopting a low carb high fat (ketogenic) diet has become the single most beneficial thing that I've done for my diabetes management and my ability to be active in the 20 years I've been living at this difficult metabolic crossroads. Eating ketogenic has improved my life and my ability to make photography, climbing and moving around in the outdoors the center of my life rather than fleeing the complications of diabetes.

I didn't expect those posts to take off because I'm not a dietary blogger. I just wanted to share the ups and downs of what I was trying in hopes that it would help other people. One of the major issues I encountered was the sharp increase in my LDL ("bad") cholesterol and initially I considered abandoning the ketogenic diet because I feared that I was just trading one risk factor for another. If you want to read that post and the comment thread check it out here!

I am writing this post to update you since two years have passed and I have found some information that I believe is useful. I also want to clarify my current position on the cholesterol issue and why my LDL is still high and why I'm not letting that fact deter me from eating ketogenic. In fact, I am going to share a couple more blog posts in the future detailing some new experiments I've been doing using intermittent fasting and exogenous ketones which has been nothing short of mind-blowing!

Exhibit A: Biohacker's Lab podcast (non-iTunes) or Biohacker's Lab (iTunes) : Ep8: High Cholesterol Levels on a Keto Diet Experiments by Dave Feldman

If you have concerns about the impact of high cholesterol on your health--specifically if your cholesterol values have increased as a result of a ketogenic diet that has otherwise improved all the "other" health markers you monitor then this podcast has some very important considerations to add to your risk management assessment.

If you've done even a tiny bit of searching about the topic of cholesterol and it's impact on health you'll know that it's incredibly complex and there's a great deal that is not known. There's also a lot of passionate exploration of opinion and theory without true authority because very few cholesterol studies have been done on people who are ketogenic. These are the realities of the murky water in which we swim as we make life and death decisions.

My own position is what I'm sharing here. This isn't my advice to others determining their position. I have measured the risk of high cholesterol against the risk of high and/or unstable blood glucose and I am willing to accept the worst case outcomes of high cholesterol over the worst case outcomes of high blood glucose. I don't say this to be flippant about risk but to clarify that risk cannot be avoided, it must be managed. I don't eat to live forever, I eat to live well first and to live long secondly. I'd like to think that eating to live well would enable me to live for a longer time but that exact dichotomy is what we are wrestling with when we discuss high cholesterol and the ketogenic diet.

I've gotten angry emails predicting my demise from people accusing me of preaching recklessness since my "cholesterol numbers are s--t". I'm still here and I'm not changing the way I eat for the sake of my cholesterol levels. I briefly tried swapping out saturated fats for unsaturated fats in hopes that this would allow me to stay ketogenic and bring my LDL down. It didn't make a huge impact on my cholesterol-and it made ketosis much less effective and it cause my blood sugar to fluctuate more. I chose to refocus my efforts on stable blood glucose, ketosis and energy production instead of sacrificing all of those markers for a minimal reduction in my cholesterol.

I made that choice long before finding the podcast I recommended above. The podcast presents evidence that would seem to validate my choice and shed light on it. I will summarize a couple of the most significant points below.

Hyperresponders are people who experience significant spikes in their cholesterol after adopting a ketogenic lifestyle for no apparent reason. Many people eating an identical diet will experience the opposite--an improvement in their lipid profile after going ketogenic. (I happen to be a hyperresponder in case that wasn't apparent thus far.)

The overwhelming majority of cholesterol hyperresponders encountered seem to be thin and athletic (like me), which would fly in the face of expectations associated with a "high cholesterol" diagnosis. This makes sense when you consider the fact that a fat adapted athlete needs to mobilize LDL for energy rather than glucose. In the absence of stored body fat the body produces more LDL to satisfy the need for energy.

The presence of cholesterol means different things depending on the context. Elevated blood cholesterol in a fat-adapted athlete signifies an up-regulated metabolism that is geared to meet higher energy demands associated with diet and activity. Elevated cholesterol in a non-fat adapted, non-athlete would signify something totally different since that cholesterol wouldn't be there for energy. It could indicate some sort of inflammation or reparative event that would correspond to atherosclerosis and cardio vascular disease--thus explaining the correlation between elevated cholesterol and heart disease.  LDL isn't the culprit itself--it's the event triggering the production of LDL that is more telling.

Looking at other factors which would illuminate the context and significance of LDL elevation (A1C, belly fat accumulation, blood pressure, inflammatory markers etc) can help us more accurately assess if our cholesterol is indicative of risk or not.

These are a few brief takeaways that really stood out to me because they offered an explanation beyond the typical refrain of "it's the particle size that matters" and looks at the different contexts that can lead to increased LDL for very different reasons. My understanding of the concepts is certainly truncated and incomplete, however these points made a great deal of sense to me given my own experience and the experiences I've had with others. I encourage others to assess and manage risk carefully according to their own research and so I hope that I have added some more perspective to consider.

I am a big fan of simplicity. I believe in working with what we know to surmise about what we don't know. As a diabetic I know what happens when my blood glucose is elevated and volatile. As an athlete I know what happens when I am sedentary and unable to exercise effectively. There is very little question about these things. Making use of a questionable diet to mitigate two very clearly known risk factors seems like a good call. To put it otherwise, if I eat a diet that helps me maintain a healthy body weight, good blood pressure, stable blood sugar in  a normal range and energy enough to train hard and often--how could that possibly be bad for me?

Anything is possible, but it seems unlikely.

Stephen Richert is a photographer, filmmaker and climber who happens to live with type 1 diabetes. You can see his professional portfolio here.

To support this project and all the creative efforts of LivingVertical become a Patron and get prints, ebooks and early access to media as part of the group of insiders driving the creative efforts of LivingVertical also please know that non-monetary support is always greatly appreciated. If you can share our work or connect us with your friends, it would be greatly appreciated!

Crowdfunding with Patreon: why it's right for "Banting's Ghost"

There are 5 days left to see if crowdfunding with Patreon will successfully launch the Banting's Ghost documentary project. My Patreon is at $391/month pledged by 29 backers. We need to reach $500/month in order to launch. I have gotten some questions about the way I am attempting to fund this project--specifically if it wouldn't be more beneficial to use a platform like Kickstarter which would allow one-time contributions of a larger amount rather than seeking the smaller, monthly pledges by crowdfunding with Patreon. Here are some facts about this project that you may not have known--and that I hope will clarify the choices I've made in funding it.

  • Banting's Ghost Documentary Project is an ongoing effort; a series. This isn't a one time production of one piece of media or even a predetermined number of pieces. It's an ongoing effort to document the lives of real people who are wrestling with the challenges of access to insulin. I believe that the greatest impact this project can have is if it's responsive. Light and fast. Guerrilla media--not one monolithic production that simply takes a position and holds it. I've chosen this kind of delivery of the documentary not only because it's what I can do best but because it's aligned most closely with how people consume media today.
  • Fewer and fewer people  sit down to watch a 90 minute documentary on Netflix. Everyone has the time to watch a 1-3 minute short on social media--or a series of stills that bring an issue to life. Sharing happens and on it grows. Shorter, episodic projects leave more flexibility and room for failure. Even the best effort sometimes misses the mark. When you're telling an ongoing story you have many more opportunities to explore different perspectives and even take risks because you'll have more chances to try again and connect with a variety of people.
  • The problem we are attempting to address through this project is complex. The solution must also involve complexity and the episodic approach is better adapted to this.
  • Having done a handful of successful and unsuccessful crowdfunded projects I know how incredibly hard fund raising is. I also know that I'm not naturally gifted at sales, specifically when I have to sell the value of my work. I want to DO the work, not sell the work. Still, unless the funding is there, nothing can be done. Patreon (monthly contribution model) allows me to do the fundraising once and then gives me a sustainable outlook for future funding which allows me to use more of my time as a documentary storyteller and less as fundraiser. If I have $750 pledged in monthly support, I can make a plan for the best work I can do with that funding. One time contributions can give a bigger bump in support but can't really be factored into planning.

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So why not accept one-time donations in addition to monthly support? What's the harm in adding more ways for people to give?

At the time of this writing I am not certain that Banting's Ghost will "go" since we are close to the end of the launch funding window and we haven't hit our target. If we can't cover the base costs then I will hold the contributions via Patreon and pause the campaign until we decide how to move forward--and no one gets charged in the meantime, no refunds have to be processed and all the support for Banting's Ghost will be managed through ONE platform. The alternative of having to chase down individual contributors and return funds adds more complexity to the endeavor.

If the project gets funded and is growing, then accepting one-off donations is no problem because I wouldn't need to be focused on building a base level of support but rather on growing the already established project.

Stephen Richert is a photographer and filmmaker who happens to live with type 1 diabetes. You can see his professional portfolio here.

To support this project and all the creative efforts of LivingVertical become a Patron and get prints, ebooks and early access to media as part of the group of insiders driving the creative efforts of LivingVertical also please know that non-monetary support is always greatly appreciated. If you can share our work or connect us with your friends, it would be greatly appreciated!

Insulin access before incremental advancement

I've always wondered how a cure for diabetes might have any hope of actually being delivered broadly enough to make an impact in the lives of those who need it most. Today there are thousands of people who are grappling with the untenable reality of insulin access while paying the ever-escalating prices attached to 22 year-old insulins like Humalog. The idea that developing the biggest ticket item ever put forth by the pharmaceutical industry would somehow lead to accessibility without a prohibitive price tag is unrealistic under the current model. Driving people to support incremental advancements that are increasingly hard to afford with no meaningful check and balance to the industry is at best misguided.

What's a documentary project going to do to fix this? An absence of voices that express the position of the silent majority is largely why I'm discussing this issue and asking for support for the Banting's Ghost documentary project. If you haven't yet guessed, the majority of people with diabetes aren't on twitter or blogging or making movies about their condition. They're not invited to attend conferences that guide the future of research, technology or policy. They are not heard in those gatherings and it's no surprise that their best interest is not represented. They are working multiple jobs, sacrificing good nutrition and leisure time that could be spent exercising or not sitting at a desk. They are worrying about how they will pay their rent AND buy their insulin. Homeless or sick? Homeless or sick? 

This is the silent majority and they don't care about the fancy new insulins that are 5% better than the "old" insulins that they still can't afford. They've never had a CGM and wonder what it would be like to know what their blood sugar is all the time so that they could relax a bit more. If this narrative sounds exaggerated or unfamiliar-that's only due to the inherent difficulty of building a successful PR campaign around the access before advancement credo. I'm done waiting for a big "community" organization to act in a way that promotes the interest of all the community--and give a voice to those who are unheard.

I know that I've spent many years of my life as part of that silent majority. When I first peeked into the world of the vocal minority (read: Diabetes Online Community) I found it to be largely well intentioned but unmistakably tone-deaf and out of step with the reality faced by most people with diabetes. I don't say this to be critical but rather to explain why I'm sticking my neck out to execute this documentary project. If it seems like I'm stirring the pot--I absolutely am. Telling these stories will raise issues to the surface that tend to be ignored--and that's really all I'm after.

Better yet, the Banting's Ghost documentary project is not about my story or perspective. Sure you'll get some of my views when it's my turn to talk but I only want to use my platform to shine a light on the stories of others who are always swept under the rug. Not just one story, but every last one of them--until the presence of the silent majority becomes too uncomfortable to ignore at the galas and the conventions--and eventually the board meetings.

Insulin access isn't a problem that I can solve with my camera but media and stories are an important step along the path to a solution. I'd argue that we haven't had a solution up till this point because those who really experience the biggest problem aren't meaningfully included in the discussion. That's something I think I can solve with my camera.

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If any part of this writing resonates with you, please support the Banting's Ghost documentary project. I'm working to get it operationally funded by the end of June and we are just over half way to our goal. If we reach July and the funding isn't there then I can accept "no" as the collective answer without feeling any sense of failure. This isn't an easy thing to sell--if it was, I'd be competing with other artists for this job. Ranting is more cathartic, inspiration is more pleasant. Reality is utilitarian, plain--and in some cases, just plain ugly.

If no one names the problem and humanizes its impact--how can we ever expect to change it?

Stephen Richert is a photographer and filmmaker who happens to live with type 1 diabetes. You can see his professional portfolio here

To support this project and all the creative efforts of LivingVertical become a Patron and get prints, ebooks and early access to media as part of the group of insiders driving the creative efforts of LivingVertical also please know that non-monetary support is always greatly appreciated. If you can share our work or connect us with people who might want to share their story, it goes a long way!

lumix panasonic micro 4/3 cameras like the g7 are excellent for street photography

Banting's Ghost: an insulin access documentary project

It might not work. These are some of the scariest words in the vocabulary of any creative and they are responsible for stifling the launch of countless projects that might have changed the world if they'd only gotten out of the front yard. As much as I've tried to turn my creative focus away from diabetes and towards the things that inspire, I feel like there is unfinished business. Inspiration means nothing without insulin when it's literally keeping you alive. That's why I'm using the platform and the talent that I have to try to make a ruckus about insulin access through a documentary project called Banting's Ghost--that will amplify the humanity in this otherwise very data heavy issue.

Banting's Ghost is the working title for this project and it will document the people who are struggling with access to insulin--not in a far off land but right here in the United States. I named this project for Frederick Banting, one of the lead researchers who discovered insulin in 1923 and promptly sold his share of the patent for $1. He was quoted as saying "Insulin does not belong to me--it belongs to the world".

Our current situation has departed significantly from Banting's altruistic vision. The system has run amok. The pharmaceutical industry has escalated prices that are untenable for insurers--who have responded by covering fewer and lesser quality options which is untenable for people living with diabetes who would like to survive. Community organizations cry, 'research for a cure' over the wailing of those people suffering because they can't afford access to 20 year old drugs.

We are expected to believe that advancements will lead to access rather than the other way around.

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Who are these people suffering and struggling you might ask? Maybe you--like me and most of those who are vocal and have time and following to share our opinions online--are still able to bear the weight of the dysfunctional system and are struggling forward under the burden in hopes that the finish line is at hand. I've got news for you. It's not. People who are struggling are not represented in diabetes advocacy--which is funded by the industry--directly and indirectly swaying those who might otherwise stand up and provide a check and balance.

I don't have all the answers. I have the ability to tell stories. It's a start. It's a missing piece of the puzzle and I'd argue that it's a really important one. I don't think that homebrewing insulin is the answer or that the diabetes industry should be decimated. I think that productive conversations begin with some empathy--or at the very least the inability to ignore a public relations fecal hurricane of stories that amplify the value of people over the pursuit of the status quo. There are a lot of data, graphs and charts out there to show that this crisis is out of control. What's missing is the living, breathing human element and that's what I'd like to amplify through the Banting's Ghost documentary project.

It might not work. How will it get funded?

True, it might not even get enough funding to leave the station, let alone gain the momentum it needs to create impact down the line. It's a bigger task than I can execute on my own, I know that much. I'm asking that if you believe this project to be a worthy endeavor that you back it with a small financial contribution. That's the only way it will fly. With a family to support and limited resources at hand--addressing a topic that is inherently unfriendly to the industry it's not difficult to see that the "fly by the seat of my pants" approach won't work this time around.

Still, I want to unfurl the Banting's Ghost documentary project in stages, according to the financial support that is available as we progress rather than waiting until all the necessary funds are in place. The first stage is a photo documentary project (inspired by Humans of NY) which is the most time efficient manifestation. My goal is for that to lead into a series of mini documentaries in video format as well as podcast episodes.

It might not work. It's something I've always wanted to try to contribute to the conversation in the diabetes community and the public and I am not afraid to fail--at least not so afraid that I won't try. Will you help?

Stephen Richert is a photographer and filmmaker who happens to live with type 1 diabetes. You can see his professional portfolio here

To support this project and all the creative efforts of LivingVertical become a Patron and get prints, ebooks and early access to media as part of the group of insiders driving the creative efforts of LivingVertical also please know that non-monetary support is always greatly appreciated. If you can share our work or connect us with people who might want to share their story, it goes a long way!


Here's why I'm thankful for film this Thanksgiving

I returned home to wade through plenty of my own personal baggage that I encountered during my time at Standing Rock. It's been heavy and not at all comfortable witnessing this unfolding of events. I went there with questions, seeking answers--and came back with more questions. I have a few more posts that I am working on which will extrapolate the details of the time I spent there and show you the images I made--but right now, I want to share something seemingly unrelated that has helped me find my center in the midst of all this tension: gratitude for film photography.

My emotional baggage wasn't the only thing that was waiting for me when I arrived home. I had sent a years worth of film in to be developed before I left for North Dakota and just as I had done while shooting it--I let it slip from my mind. As I was in the process of unpacking my bags and cleaning up my camera gear I got an email with a link to the scanned negatives. Clicking through these "lost" moments from the preceding months was like a reprieve from the inexorable passage of time. It filled me with gratitude for everything I've been able to experience and share--and that feeling of gratitude lifted the burden of baggage. It's enough of a privilege to live my life enjoying technology and travel--adventure and photography--it's even more of a gift to have the opportunity to create little time capsules that distill the journey. It's also a complete privilege to have you reading this because as I've said before, no one is entitled to an audience.

As I clicked through, I  found pictures of my friends Rob and Chris--just being themselves. I found pictures of Lilo from when she was much smaller. I found pictures of Stefanie from little moments that had held no great significance other than the fact that they'd never come again. I found the last photographs of my friend Pittman before he took his life. Looking at each image I was taken back to a moment in the past that I felt something worth capturing--usually a sense of tension and finality as I pushed the shutter button. I didn't know what I'd make or how the photograph would turn out. Once you push that button it's too late to edit or second guess. It's done. I was afraid of trying to capture something intangible and just barely missing it--tasting the success just enough to make the failure that much more sour.

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I know that people are afraid of a lot of things in these uncertain days. I am too, I guess. Regardless of your social or political views, things are pretty dark out there. That's something we can all agree on. I don't know that pointing a camera at things will make anything better objectively. I don't even know what is better objectively. I do know that I have a lot to be thankful for and that fear and ignorance are not good enough reasons to stop creating and exploring. Diabetes taught me over the years that life is what we make it and that creation is the opposite of destruction. That is, and will always be the truth that drives me to keep creating even if I miss the mark by miles. It's not the mark that matters in the end--goals, targets and objectives always change. It's the willingness to take aim and try that I'm thankful for.

Film photography isn't about perfection. It's simply not the best way to make the most technically precise photographs. There is too much left to chance and variables that are difficult, if not impossible to predict with regularity. Still, the process of letting go and eventually getting a return is incredibly satisfying. Maybe it's because there are no guarantees or do-overs. You get one chance to get it right and when you do, it feels that much better.

Standing Rock: Examining my bias

As a photographer it's my job not just to re-create what I see in the world around me but to take some responsibility for my interpretation of it. This fact made the task of remaining unbiased while photographing at Standing Rock--exceedingly difficult. The inherent tension between accuracy and interpretation is something that thrills and terrifies me. It's a tenuous balance of being entrusted with a sensitive story--wanting to do it justice while avoiding being swept away by my own raw emotion gathered through the experience.

If you have no idea what is going on at the Standing Rock Sioux Reservation or why I went there, I urge you to do a little digging to find sources who have reported on this conflict and its background context. The story is almost invisible in the mainstream media and I am not a reporter as such. My hope is that my sliver of shared experience and photographs from the Oceti Sakowin camp on the Standing Rock Sioux Reservation this past week will help create enough tension that you may look into the facts and form your own opinions. It's an historic moment in our history, with over 200 tribes from all over the United States represented--the largest such gathering in modern times, catalyzed in response to the Dakota Access oil pipeline (DAPL) which is slated to run through treaty land, just upstream from the reservation water supply. The pipeline also will run through sacred native burial sites. These are the facts--not my opinion about them.


Speaking of opinions.

I hadn't really encountered a situation in my photography where I was pointing my camera at something so socially charged without the security of knowing how and why I felt about it. My previous work in diabetes advocacy is something I live daily so my work was my opinion in that context. I knew where I fit in.

How could I form a valid opinion on the Standing Rock situation? It's barely a hiccup in the mainstream media and furthermore it has deep racial implications. I'm on the outside. I'm white. I've never lived on a reservation. I don't know what it's like living in a community with 80% unemployment where the Dollar Store is literally the only grocery store for miles around. Growing up, colonization to me, simply meant the process through which we got here. To many indigenous people it means an ongoing process through which their culture was largely decimated and the lever by which they were displaced from their homeland.

There is an obvious chasm between my world, which is largely insulated from this struggle, and the perspectives I encountered at the Oceti Sakowin camp. I will be wrestling with this disparity for a long time to come--possibly without any clear resolution. Not looking away from difficult realities is where I can begin. I don't make apologies for who I was born or where my ancestors originated. During my time at Standing Rock I didn't feel as though I was expected to do that. I was accepted as a guest and often greeted kindly as a non-native relative. Receiving respect in the face of so many generations of sadness and injustice made me want to find a way to just make it all better. Staunch the bleeding. It also made me more determined to not let my feelings interfere with my photographs. Still, those feelings are what drove me to travel from Massachusetts to North Dakota over 3 days to make those photographs.

Clear as mud, yes?

I've had some people take offense at the fact that I've even been willing to look at this story in the first place--as if recognizing that the situation exists is tantamount to taking sides. There are certainly others who feel as if anything other than explicit activism for the NoDAPL cause is irresponsible or exploitative. I don't share either of those views--but still, they aren't wrong.

To whit:

The presentation of lethal force against peaceful, prayerful demonstrations that I experienced is not business as usual. I learned as a child that you never point a loaded weapon at something (or someone) unless you fully intended to pull the trigger. Yet, at one point, I stood at the police blockade with two other journalists and a Marine combat veteran--only four people armed with questions and cameras--who asked respectfully to speak with the commanding officer. We were met with mockery, a drone hovering overhead and more than 10 heavily armored men watching us through the scopes on their weapons. I still don't know if they were police or military. No one would identify the agency under whose authority they were operating. I made their photograph as I am certain they made mine. I would have greatly appreciated a chance to tell the other side of the story, but all I saw of the other side was armored vehicles and the business end of a lot of big guns. I wouldn't say I took sides in that moment--more like I was forcibly relegated to a side.

I was walking back into camp after this incident took place and I was confronted by a young woman with a camera of her own. She asked me who I was reporting for and I explained to her that I ran my own website and was out there on a self-directed project to document the situation. I shared that a lot of this was a learning experience for me because I felt strangely trapped between two worlds. It didn't take her a long time to explain that unless I had plans to report on every oil pipeline on native lands--not just the one that was trending on Twitter that I was just a looky loo. Part of the problem. Another tourist out on a camping trip taking snapshots. Perpetuating genocide, she said.  Maybe she was just being overly sensitive towards a competing photographer.

I still worry that somehow I was actually taking more from the native community than I could give back despite my best efforts and she unwittingly put her finger on the truth.

Hello, uncomfortable tension.

I went to Standing Rock without a fully formed opinion, knowing that I would begin to assemble one through my experience--which would ultimately not even scratch the surface. I went there and saw things. I felt things that impacted my views. I'm human, flawed and willing to empathize with people I don't agree with or understand. I don't know if it's possible to look at people suffering with dignity and feel nothing. My purpose in breaking up these posts on the blog is to compartmentalize some of these competing reactions that I had internally. I don't intend for the sum of my opinions to be the ultimate takeaway so it's important to give my feelings some outlet that is distinctly separate from the photographs themselves. Dealing with this tension through the creative process--that's the takeaway.

If all this duality makes you uncomfortable--I assure you it only gets worse from here. Or better.

I'm going to Standing Rock, ND--here's why.

I'm not political but I'll give it a whirl for a moment.

I don't rant incessantly about who is ruining the country or who should fix it. I'm pretty sure that's what voting is for--a place to contribute a meaningful impact (as opposed to berating people on social media who disagree with you for seeing the world differently). The truth is that your opinion doesn't matter--only your actions do. This wildly unpopular view is the only hope have we have as a society of self-rescue--because the worst leadership wouldn't be able to capsize a nation of people who were humble enough to link arms across various lines of race, ethnicity and politics.

Ok, now that's out of my system:

A few days ago I felt like I should go to Standing Rock in North Dakota to do a photo-project documenting the protest about the Dakota Access Pipeline there. I don't have an axe to grind. I'm not a protester. I'm a photographer who believes that pretty images aren't necessarily the most important. For those of you joining me in the Ugly Camera Challenge I wrote about recently--I absolutely will be continuing to participate in that (and I hope you will too!) It feels as though something deep and significant is under way in the Standing Rock conflict right now and for the last few weeks we've heard almost nothing about it in the media. Nothing from our political leaders who are selectively concerned about the dire implications of climate change but refuse to even acknowledge this debacle that is unfolding on our own soil.

You may agree or disagree with my decision to go to Standing Rock, North Dakota and point my camera at something that no one seems to want to deal with. I'm writing this to articulate my purpose in going. I'm not attempting to shame others who can't or won't join in this journey. I have the privilege of time and opportunity to travel. I have the freedom (risk) of no allegiance to a commercial sponsor or assignment other than my own self direction and those of you who are supporting me on Patreon (thank you!!!). I have a supportive family who is making it possible for me to step out and do this. I'm thankful for those gifts and I don't deserve them any more than anyone else does. I don't believe we are given gifts in life to squirrel the benefits away away while turmoil engulfs others who have drawn a different card.

I have no idea what I will find out at Standing Rock. I'm not going with any opinion other than this: my opinion doesn't matter. What matters is that there is not a public and transparent discussion of a militaristic-type of force being used on civilians who are peacefully protesting corporate development that directly impacts their land. I suspect that as with most conflicts in life there is a combination of people doing the right things for the wrong reasons--and people doing the wrong thing for the right reasons.

One of the cop-outs of the photographer is that the camera doesn't have an opinion. It's not biased. It accepts us as we are--the good and the bad. The humanity. I'd like to think that I will return with some images that may make us think about this conflict from a more personal standpoint. Because that's all any of us are, after all. We're just people. If we can only use our technology to start arguments rather than conversations then we have already failed, utterly. On some level that's the hurdle that I now have to clear as I go out to photograph.

I feel a lot of creative tension around this.  I don't know the outcome and I am fairly certain that this choice will alienate more than a few people who I consider important in my life. I feel real risk. Some fear. I don't know that I can do this without making an ass of myself or getting in the way of a cause that isn't my own. I know that this might not work.

I know that it still feels right to go and try.

I'm not sure what will come from this effort in terms of deliverables. My primary goal is still images. Interviews, stories, video assets and the like will be a bonus that I hope to capture as well. I'll update via LivingVertical social media channels as I can. Cell and data service are reputed to be lacking within a 20 mile radius of the reservation so I may be quiet for (the first time in my life) a while. If you'd like to support this work I'm doing, you can contribute via my Patreon page. If you'd like to tell me to go _______ myself, sound off in the comments below--or better yet do it in person.

The Ugly Camera Challenge: minimalism in photography

It's nearly that time of year when all of our camera gear suddenly becomes too limited and obsolete--usually as a result of proximity to Black Friday sales. I've watched the #OptOutside initiative grow over the last year or so--with the goal of encouraging people to redefine the day after Thanksgiving in a less materialistic light by scheduling outdoor adventures in place of shopping. Being a bit of a skeptic, I think that this is likely just clever marketing meant to snag sales in early December but despite that, I appreciate the idea of doing more with less.  The Ugly Camera Challenge is geared towards applying that same minimalism to our adventure and photography!

Full disclosure: I struggle with G.A.S. (gear acquisition syndrome) as much as anyone else and my goal here is not to bare my soul to the world and repent of my love of cameras. I've accepted that it's part of who I am. Aesthetics of new gear entices and inspires new adventures. On the other hand, limitations are an absolute key to creativity. Thus, the Ugly Camera Challenge which can help us selectively limit ourselves while getting more mileage out of gear we might otherwise neglect.

The rules of the challenge are pretty simple:

  • Make 1 photo a day with YOUR "ugly" camera every day in November
  • Share your posts on social media using the #uglycamerachallenge tag
  • In early December we pick our favorite shots. You can email yours to me with any relevant notes, thoughts or lessons learned and I'll post our favorite images here on the blog!
  • Have fun!

A few notes about the challenge:

  • I've intentionally left room for some creative interpretation. The goal isn't to specify exactly what to shoot or how--but rather to try embracing limitation to see what creative growth comes from it.
  • I'm not calling your camera literally ugly--it's a figure of speech. The idea is to shoot with something that is a little "off the beaten path"
  • Since I am going to be shooting film as my interpretation of this challenge, I am going to leave enough time to get film developed before sharing the results on here.
  • I've included some ideas for "bonus points" below. I'd love to hear your ideas too--drop a comment below and let's make this fun!

Buy a used camera from a person (ebay, yardsale, craigslist, barter) that is deplorably cheap. Let's say $50 or less. They are out there! Film or digital--let your mind wander a bit!

Give your ugly camera away to someone who doesn't have one-this could be a young person who only knows cell phones and has never gotten to experience simply shooting photographs, someone who is interested in photography but can't afford a "better" camera--you get the idea.

Get a friend, a child or a spouse involved--these kinds of things are more fun with group participation! This could easily create a pathway to mentorship. I'd love to see us getting more mileage out of gear that we would normally not even bother to pick out of a trash bin--and then passing it on to someone else along with whatever lessons taken from participating in this challenge!

This could easily be integrated with the OptOutside initiative--and I think it shares a lot of the same ideals of minimalism and prioritizing experience. Having a camera imposes the need to go somewhere, do something and shoot it. Plan adventures outside--small, local or whatever to document through this month!

Photography is a gift and the simpler we make the experience, the richer it becomes--to borrow the words of Steve House. I want to point out that this initiative was inspired by Ted Forbes from The Art of Photography--his video may help inspire you further!

banff national park climbing

Why I'm done dwelling on diabetes

Our identity is the first to suffer the complications of diabetes. It changes how we see ourselves--normalcy and belonging grow distant. Limitations germinate quietly like mold beneath the occluded layers of personality we create every day in order to just survive. It's the hairline fracture in the foundation of who we are. The deeper it goes the worse it gets.


I started LivingVertical to share Project365--my goal was to change the story of diabetes and show that we don't have to accept the narrative of a predetermined outcome of victimhood. I still believe in that same message, but I don't think the best way to communicate it involves creating content about diabetes anymore. I'll always have diabetes and I'll always be happy to answer questions about my experience with it--if I can help, I will do so gladly. Where it's relevant, diabetes will still be visible but it's not going to be the focus of what LivingVertical is creating. It will always be in the picture but it won't be the focus. I believe it's more important to demonstrate that life with diabetes is about LIFE. This is the most powerful advocacy I can offer. It's also a choice I am making because I'm frankly tired of trying to pack my world into the topic of diabetes. I'd much prefer to make diabetes fit into the world I'm choosing to explore. 


I'll explain.

I've always  had a hard time gaining a foothold in the diabetes online community. I suspect that's because my approach has been to encourage people to detach their identity from their diagnosis--because that's what worked for me. It's a tough sell though. A diabetes-free mentality is why I never stopped to think that I couldn't climb mountains as a teenager. It's why I thought it was perfectly acceptable to spend a month hiking the Appalachian Trail and take on solo adventures without trepidation in college. It's why I've driven across North America more than a dozen times (half of them solo) and I don't fret about changing my lancets daily. I didn't have olympic athletes and professional spokespersons with diabetes to assure me that I could do anything. I didn't see myself as a diabetic who climbed or who hiked. I didn't see myself as a person with diabetes. My identity had ZERO inclusion of diabetes--so why wouldn't I be able to do anything I put my mind to?

I wasn't in denial about my diabetes--no more than I've been in denial about brushing my teeth daily. I just never placed that task inside of my identity. Diabetes was a task--one that I realized was incredibly significant. I detached from it emotionally and executed it to the best of my ability so that I could have the freedom to pursue what I loved. Others might call this unhealthy, compartmentalization or repression. I call it freedom through discipline. I have staked my life on this philosophy repeatedly in the mountains and elsewhere. It's not a perfect science but it's been able to give me a winning average. I believe that it's the greatest value I have been able to share here.

Why is this all written in the past tense?

Sometime in 2012 I found that I had to include diabetes in my identity in order to reach others living with diabetes. I had to create space for it where it none existed before. I became the "diabetic guy who climbs things". I'd introduce myself to people that way. It changed the way I saw myself. It changed the subtext of the story I told myself about who I was. It wasn't healthy--literally. I know that many people have found value and connection through an inclusion of diabetes as part of their identity--and I don't begrudge them.

For all the value, impact and success that came with my diabetes advocacy, my own independence from diabetes atrophied. Spending 7-12 hours a day for the last 5 years writing, filming, posting, blogging, emailing, pitching, podcasting, publishing--all through the lens of diabetes--multiplied the weight of diabetes in my life. I wasn't just living with it--I was living IN it.

 So what's the point?

  • First, protect your identity. Be someone outside of your diagnosis. Maybe the "person with diabetes vs diabetic" debate is asking the wrong question altogether. The terminology isn't the biggest concern--it's the inclusion of a malevolent entity in our self image that should raise red flags. Execute the physical tasks necessary for your body to gain independence on behalf of your mind.
  • Second, I'm thankful I've had an opportunity to dig deeper into my diagnosis through my advocacy here. I'm not regretful about what it cost me. I've gained a different perspective on just about everything and that has enabled me to make some wonderful friends. That's what I consider you.
  • Third, when you reach the last page in the chapter--start a new one. Don't keep rewriting the last paragraph for years until you wither in frustration. Find what excites and motivates you and go unapologetically towards it even when it seems impossible.

Photography and adventure will be the focus of LivingVertical content moving forward. I believe this is the greatest value I have to give--unpacking the tools that have given me my life back. I think this is less a change of priorities and more of a return to them. There's a reason LivingVertical doesn't have "diabetes" in the name. It never occurred to me to put diabetes in the name of my endeavor when I arrived on the scene 5 years ago because it wasn't meant to focus on the problem but rather the solution. Walk the walk--even if it interferes with talking the talk.

I'm grateful for your readership up till this point. I hope you'll join me for this next chapter. I suspect that many of you who actually read my posts all the way to the end aren't here because of factual information I share as much as my interpretation of what I see in the world around me. If that accurately describes you then it's a good bet you'll enjoy what comes next!

I want to thank specifically Blake McCord, Ashika Parsad, Sysy Morales, Maria Qadri, Fatima Shahzad, Ryan Little, Matt Spohn, Andres Arriaga, David DuChemin, Rob Muller, Tyler Smith, Joel Livesey, Mark Yaeger, Carter Clark, Christine Frost and Nate Duray for inspiring me to have the courage to return to a diabetes-free mentality. There are many others who have contributed to my liberation--knowing or otherwise. Far too many to list here--but these folks have listened and shared in the deliberative process over a long time and I want them to know how much I appreciate their example and wisdom.

here's a story about why I'm trying a modified Ketogenic diet

Why I'm trying a modified Ketogenic diet

A little over a year ago I was bored. I was working in an office environment and not able to get out climbing. I wanted to try something to shake up my routine despite the obvious constraints. I decided to do an experiment with a vegan diet, which ultimately led me to try the complete opposite--a ketogenic diet. This bit of skylarking wound up taking off and got this humble blog ranked #1 in Google for the search terms "type 1 diabetes and the ketogenic diet". This happy accident has brought many of you here no doubt although it's left me with a burden of continuing to write about a topic that I feel has been wrapped up (at least in my life). The notable exception is the modified Ketogenic diet which I am currently following.

There is one loose end, however--and that is the issue of high cholesterol. I also have the dubious honor of ranking very highly in Google searches for ketogenic diet and high cholesterol--a pleasure that I'd prefer to postpone indefinitely. I am still working on sorting out the details on my high cholesterol and what it means for my adherence to a low carb, high fat ketogenic diet. There is a dearth of information available that gives simple, clear insight into the topic of cholesterol--and much less still when you add type 1 diabetes into the mix. Half of the discussion resembles this: "Cholesterol is not a problem! Eat more butter and stop listening to the man!" The other half resembles this: "Cholesterol is a HUGE problem! Eating that butter is going to kill you!" I would like to believe that a modified ketogenic diet could win the middle ground between these two viewpoints.

The ketogenic diet stabilizes and controls my blood sugar without technology. This fact alone makes it an asset that could revolutionize the impact of diabetes if given the chance--especially significant for the millions of people who can't afford higher tech solutions. It gives me the simplicity and freedom that allows me to live out from under the burden of diabetes about 90% of the time. Still, living with the cholesterol monkey on my back is a concern.

I feel as though I can choose to either optimize cholesterol or blood sugar--but not both.

I choose to optimize blood sugar because there is no lack of conclusive clinical evidence showing what uncontrolled blood sugar does. There is also no shortage of anecdotal evidence showing how much harder it is to be active, creative, happy and productive while riding the glucoaster. Without getting all morose, let me just say that I have chosen my priority. It's not an easy choice and it gives me a lot of stress and grief--but it's the best I know to do and I am prepared to live or die with the consequences.

Welcome to my life with diabetes and climbing. These types of decisions are par for the course.

What I have learned with the help of my doctor (he is an amazing endocrinologist who is supporting my blood sugar management despite its unorthodox approach) is that I am most likely a hyper-responder to saturated fat. This is a genetic anomaly that causes my body to produce exponentially more cholesterol in the presence of saturated fats. The detriment of that cholesterol is still undetermined--along with the possibility or being able to reduce it.

Thanks, genes! The diabetes was a sweet offer--but wait, there's more...

In light of this hypothesis, I am not abandoning a low carb, high fat diet but I am following a modified ketogenic diet. I believe that most people have to modify whatever diet they follow in order to accommodate their specific needs. A modified ketogenic diet can, of course, mean many different things--it is not imply any one specific modification. I am trying to add more unsaturated fats in place of saturated fats. In simplest terms that means that I am eating more olive oil, macadamia nuts and fish. I am eating less red meat, eggs and coconut oil. In a lot of ways it's closer to hybrid mediterranean diet. It's really hard to sell this approach since it doesn't fit with the self congratulatory memes of the vegan "path" nor the devil-may-care tropes of the ketogenic community. Oh well.

My cheese intake is still predictably unaltered. I will be buried with my block of Coastal Cheddar and a paring knife if need be. Nuff said there.

I recently started swapping out olive oil in my coffee rather than coconut oil. Before you gag and click away, I have to tell you that it's actually delicious if you put it in a blender. I'm still putting heavy cream in my coffee with the olive oil. Additionally I am eating more leafy greens and cruciferous vegetables (red cabbage, brussel sprouts) as vehicles for more olive oil and more fiber. I've cut out a lot of red meat--not to complete exclusion but I'll eat a steak or some lamb once a week rather than twice or three times weekly. Meat ends and deli meats which I love--have been largely replaced with macadamia and Brazil nuts. I am also increasing fiber intake through the vegetables and adding chia seeds to just about everything I can.

I'm not on statins currently--but I am taking fish oil, vitamin D and Berberine as part of my normal supplement routine of magnesium and potassium.

I don't have any solid numbers yet to indicate the effectiveness of the modified ketogenic diet on my cholesterol. In terms of its impact on my blood sugar and energy, I feel like it takes a little more olive oil to get into ketosis. It's lower caliber--but it still seems to be getting the job done. I've been taking more insulin recently--but I am not sure if this is because I am back living in Massachusetts or because of the dietary modifications. I have always found a dramatic decrease in my insulin dosage when I am out west (10-15% consistently). On the flip side, I have more time and space to focus on my diet and supplementation here than I did when we were living on the road.