About the Author, Mary Patterson: I’m a rock formation loving dog mom, military spouse, college professor and roller derby referee. When I was a child, I hiked the Approach Trail with my family from Amicalola Falls to Springer Mountain and always wondered what it would be like to just keep going. So, 25 years later, I’m feeling called to embrace the suck, bloom where I’m planted, and take on the challenge of a thru-hike. My favorite author, Flannery O’Connor, wrote, “Be properly scared and go on doing what you have to do.” This is my mantra for the AT.” You can also find her on Trailjournals

To see more posts from Mary, click her name above!

“Should I be worried that I’m not worried?” The question recently woke me up at 2am. As thru-hiker season is getting underway on the Appalachian Trail, forums have begun filling with frantic questions by aspiring thru-hikers consumed with cutting base weight, ramping up physical training, planning travel logistics, and exerting a general paranoia that they aren’t prepared for this. The standard response, “You’ve got this!” seems to do little to assuage their fear of failure as they compile their spreadsheets and fret long into the night about resupply, making friends, weather, and the like.

Checking out mileage and resupply options

In overplanning, hikers attempt to exert control over the unknown. I just hope they remember to enjoy themselves on their adventure. While I’m not particularly worried about anything trail related beyond spotting signs of tick-bourne illness, there are some additional considerations I’ll need to make as a hiker with my own plethora of health issues.

As someone who has lived their working life with a great degree of predictability -lesson plans, grade books, and carefully designed curricula year after year – I’m looking forward to the unknown and unpredictable. There are certain things I know I can control about my days on trail and certain things about a hike that are going to be out of my hands.

Even though this is essentially a 6 month walkabout where no one is going to carefully monitor me, I will need to be vigilant for signs of impending flare ups of endometriosis and Sjogren’s syndrome.  I’ve heard people write these diseases off as “bad times of the month” and “dry eye and dry mouth,” but beyond the severe pain, fatigue, and mad pooping that endometriosis can cause, Sjogren’s can also cause swollen joints, chest pain, fatigue, eye pain, weird rashes, fever, swollen glands, headaches, and painful mouth sores.

I won’t forget my brace again

Because none of these is fun to hike with, I plan to hike longer days when I’m having a good day and rest more on the creaky days. If that means staying an extra day in town, resupplying with a “Nero” day or taking a “Zero” in the woods, I’m planning to send a bit of extra food in case the town options are slim or I’m not making the miles I had planned on.

A lot of what miles I will make will be dependent on the weather which affects my pain levels, my own body’s limitations as I start burning calories and building muscle at a much higher rate than I’m used to, and how long I can realistically go without a shower and fresh food. Thankfully, Sjogren’s causes dry eyes and mouth and a humid environment can help this significantly. I keep a humidifier on in my room at night over the winter and I’m about to become one with a trail that’s often referred to as “The Appalachian River,” so this bodes well.

I am having three eye procedures done ahead of my trip. One is to have dissolvable collagen plugs inserted in my tear ducts to keep my eyes from constantly tearing up and washing the moisture out. The other is a treatment called Blephex that removes the gunk from the insides of your eyelids and then a third called Lipiflow heats an oil gel in cups over your eyes to help stimulate moisture glands. It sounds totally gross because eyeballs are gross, but will hopefully keep me from constantly feeling like I have sand in my eyes when the wind blows, which it definitely will on Mt. Washington. I’ll be bringing special eye drops with me and will send them along in resupply boxes. This brings me to my trail diet plan.

Part of my trail prep has involved putting together several maildrops including some food items which would actually be a luxury if normal hiker food didn’t cause excessive cathole digging on my part. In backpacking videos and blogs, previous thru-hikers have mentioned that a diet of pop-tarts and chips saps their energy, which I already generally have less of. Normally, hikers are able to resupply with whatever prepackaged delights they discover in hiker boxes, salty gas station food, and the quintessential shelter staple, the gloriously chemical laden ramen bomb.

Because my autoimmune disease is inflammatory and presents itself in flares of arthritis, IBS, and pain, I mostly keep to a Mediterranean diet at home. I take disease modifying anti-rheumatic drugs, hormones to keep endometrial tissue from growing, magnesium malate tablets, and flaxseed oil capsules, which I plan to continue while on trail.

Back home, I eat a lot of fish, grilled chicken, fresh vegetables, and healthy fats. I’m not on a strictly ketogenic diet, but do need to balance carbs and lean meats while limiting nightshades, gluten, sugar, alcohol, and processed food. I’m also not necessarily gluten intolerant, but I do find that there’s a certain threshold my body reaches and then bad things happen (possibly because it breaks down into sugar and sugar fuels the inflammation and pain, but I’m not a doctor of anything medical to know this for sure). So, how does one find diet balance on trail? Being honest, you probably have to spend a bit more time and money.

A lot of people have suggested a dehydrator. However, I realized that by the time I bought all of the necessary gadgets such as a vacuum sealer and all of the food to dehydrate, it would only be a little more expensive and far less time consuming to purchase healthy backpacking meals from people who know way more of what they’re doing.

While slightly more expensive than the standard Mountain House fare, I did find three brands that work well with my diet: Heather’s Choice, Next Mile Meals, and Good 2 Go. While this is in no way an endorsement or product review, I was able to purchase a wide enough variety of these meals to supplement my other options: tuna and oil with various rice sides, peanut butter and dried fruit wraps, and hopefully some supplemental town options. I bought a ton of flax/hemp oatmeal variety packs, protein bars, salmon jerky, gluten free granola, almond butter squeeze packets, dried fruit and nuts, and most importantly, good coffee to get the day started.

Trying to find healthy variety

I have since experimented with gluten-free mac and cheese in my cook pot, which does take a significant amount of fuel and water, but cold soaking for a few minutes prior with some dehydrated peas (I bought those from the local bulk foods store) and then adding a flavored tuna packet, well that’s pretty fancy by trail standards. So, I won’t be doing MSG laden all you can eat buffets, challenging myself to half gallon ice cream chugging contests, or visiting a lot of brew pubs along trail, but, I am excited for guacamole salads and grilled chicken wraps in town – real food to fuel my body and keep inflammation at bay.

Medication is an additional consideration when thru-hiking with a chronic illness. My medication comes from a military treatment facility that doesn’t quite get my need for a 6 month supply. I see random doctors on rotation every time I go and the best I could swing was 90 days worth of anti-rheumatics. Sometime in August, I’ll have to call ahead to verify that a town pharmacy has my prescriptions in stock and then physically get there to present my old prescription bottle, wait while they verify with the military treatment facility, pay out of pocket, and potentially zero for an additional day or more or wait in limbo if it’s a weekend or holiday. Forced days of rest is generally needed for impatient thru-hikers, anyhow.

I will have plenty of town stops for picking up resupply packages. Currently, I’m planning 7-8 for the northern half of the trail and another 7 or 8 for the southern half with probably some additional packages of fresh shoes, new socks, seasonal gear, and possibly my spare set of trekking poles. Our spare bedroom currently looks like an Amazon warehouse, but I am as prepared as I can be to walk 14 states with autoimmune disease that’s always a one-person surprise party.

Getting out there!