Insulin Needs—and Insulin Heroes—After the 2022 Flood

 

Tedd Link, of Hindman, Ky.

It’s been more than half a year now since last year’s catastrophic flood upended so many of our lives.

And for people in our area with diabetes, the flood had a particular impact— especially on folks who need to take insulin to regulate their blood sugar. Not only did some diabetics lose their insulin due to direct damage that floodwater caused to their homes, but because many people store their insulin in the fridge, many more had their supply affected by the widespread power outages that persisted across the region for days (and in some cases, even weeks) on end, in the wake of the flood.

And this was on top of the intense isolation that thousands in the flood zone felt in the days and weeks after the disaster, due to the destruction of so many vehicles, roads, and bridges. All of which, combined with power, phone, and internet outages, left many diabetics, including some with desperate need, with no way to get more insulin.

But in the midst of this insulin crisis, local people stepped up, in a massive way, to help. And in this radio story, we meet some of them.

First, we meet Tedd Link, a resident of Hindman, Ky., in Knott County, who went nearly three days without insulin—or food—in the wake of the flood. While Tedd’s apartment didn’t flood, he did lose power, and he wasn’t sure if his insulin would still be safe to take after getting warm. So, he stopped taking it. “I was really getting sick,” Tedd says. “My mind was racing like a racecar. And my body… I felt sluggish, and I just wanted to sleep.” Then, we hear from Alice Caudill, of the Kentucky River District Health Department, who found Tedd and and let him know his particular kind of insulin would still be safe for 28 days, even after it got warm— news which came as a huge relief to Tedd.

“We just loaded our cars with food, and insulin, and monitor kits, and whatever we thought they would need, and kind of just went through the community handing out whatever, wherever we could get to.”

– Mendy Boggs, Community Health Worker, Mountain Comprehensive Health Corporation, Letcher County

Then, we meet Mendy Boggs & Mary Collins, two health workers with Mountain Comprehensive Health Corporation in Whitesburg, who together helped organize a large, ad-hoc, insulin donation and distribution effort in the days and weeks after the waters went down. Collecting donations of insulin and other diabetic supplies from near and far (including from as far away as New York City, and California), they helped connect diabetics all across the flood zone with life-sustaining medication— all while also helping anyone else along the way who might’ve needed it.

All of these months later, the flood is, of course, still affecting so many of our lives. But Tedd’s, Alice’s, Mendy’s, and Mary’s stories show just a glimpse of the massive—and seriously inspirational—determination, creativity, and resilience that people in our region have shown in the midst of this monumental crisis. Press play above to hear this story, or click below to read a full transcript.

Music in this story was performed by Glenn Jones & Laura Baird (“Across the Tappen Zee”), and Don Bikoff (“Traveling Riverside Blues”), both from the Free Music Archive.

Click here for the full transcript of this story:

 

[NARRATOR]: For Tedd Link, who lives in Hindman, the worst part of last summer’s catastrophic flood might not have been the flooding itself. But the days after.

[TEDD LINK] I was really sick; I was getting sick.

[NARRATOR]: Tedd has type 2 diabetes, and so to regulate his blood sugar, he needs to take insulin, which he keeps in the fridge. But he lost power during the flood, so there went the fridge. And on top of that, Tedd is new to having diabetes, so he wasn’t sure at the time if his insulin would still be okay after it got warm. So, he stopped taking it. And it wasn’t long before he started to feel the consequences of uncontrolled blood sugar.

[TEDD] My mind was racing like a racecar. And my body, though, I was just— I felt sluggish, and just— I just wanted to sleep.

[NARRATOR]: And to make matters worse, Tedd, and everyone else at his housing complex in Hindman, was largely cut off from help after the flood.

[TEDD]: We had no food. We had no water. We had no power. We had no internet. We had nothing.

And none of us here drive. So none of us could get out to where the services were. 

[NARRATOR]: So Tedd needed insulin help, desperately. Enter Alice Caudill, from the Kentucky River District Health Department. After the flood, Alice was out delivering food and checking in on people all across the county. She stopped into Tedd’s housing complex on a hunch they might need some help, and, lucky for Tedd, she also just so happened to be a diabetes educator.

[ALICE CAUDILL]: He didn’t know, really, that I was a diabetes educator. But since I was bringing food, he said, ‘Do you know anything about storing insulin?’ And here I could answer his question.

[NARRATOR]: Alice was able to tell Tedd that, even after it got warm, his particular kind of insulin would still be ok to take for 28 days.

[ALICE]: And he also told me, I haven’t been eating. He said I’m afraid I’ll have a low blood sugar. I said, I was never so happy to feed someone.

[TEDD]: After the third day, I finally got something. You know, I took medicine and got something. But it was 48 hours, almost three days, without insulin and without medicine and without food. 

[NARRATOR]: While the details of Tedd’s story might be unique, he was just one of thousands in East Kentucky who went without medication or access to care in the days and weeks after the flood, due to the serious isolation that was caused by the destruction of vehicles, roads, and bridges— all of which stra nded many people wherever they were. And that on top of widespread power outages, and internet outages.

And when it comes to diabetes in particular, the flood hit this region hard. East Kentucky has higher rates of type 2 than the state and national averages—and many diabetics in the region, like Tedd, either lost their insulin or diabetic supplies, or got cut off from help, or both.

And after the water went down, it was this very problem that some Letcher County health workers set about trying to solve.

* * *

[MENDY BOGGS]: And it kind of reminded me of Hurricane Katrina, when people were stuck on their housetops, saying, ‘I need help, I need help.’ And we kind of had that here. So that’s when we realized that we had to do something, quick.

[NARRATOR]: Mendy Boggs is a community health worker with Mountain Comprehensive Health Corporation, or MCHC, in Letcher County— which was also hit hard by the flood. On a normal day, her job involves going door-to-door to check in every week on a set of local diabetic patients, to make sure they have the supplies, the support, and the knowledge they need to stay healthy. Many of these are people who might not get the care they need otherwise. So, her job was important already. And then came the flood.

[MENDY]: Yeah, because a lot of people went at least four or five days without power. So that insulin— even if they didn’t lose their home, they probably still lost their insulin, because most of it has to be kept in the refrigerator. So, a lot of them, even if they could get out, or didn’t get affected by the flood, they still lost their insulin. 

[MARY COLLINS]: It’s not just their insulin, but it’s supplies they need.  Whether it be syringes or pin needles, and glucometers and test strips and continuous glucose meters.

[NARRATOR]: And this is Mary Collins, a nurse practitioner and diabetes specialist who works closely with Mendy at MCHC to care for their diabetic patients. We first spoke with Mendy and Mary late last summer.

The flood spared Mary’s house, but it did destroy both of the bridges that were the only way in and out of her home community of McRoberts, in Letcher County. So, Mary was stuck at home. Without cell phone service.

[MARY] When the floodwaters hit, that was what broke my heart— my patients need something, and I can’t give it to them.

[NARRATOR]: Stuck as she was, though, Mary was able to borrow a neighbor’s phone to check in with Mendy, whose house was okay and who was still able to get around. As they shared their experiences of the day and started to put together just how huge the scope of the flood was, they realized that diabetics in the community were about to need a lot of support, especially in needing insulin and other supplies. So they thought they’d try putting an ask out on social media, just to see if they might get any bites.

[MARY]: I think my first Facebook post was: ‘If you have diabetes supplies, message me. If you need diabetes supplies, message me.’

[NARRATOR]: Before they knew it, messages started rolling in. In some cases, it was nearby pharmacies, or even medical supply companies who were offering to donate extra insulin or supplies. But in a bunch of cases, it was just regular people, wanting to help out.

[MENDY]: We had a lady from London, Ky., call, and she had insulin pump supplies. ‘But,’ she said, ‘I don’t have any insulin to go in them.’ But then the next morning, we had a lady from West Virginia call, and she said, ‘I have insulin, but I don’t have any pods.’ And I’m like, ‘That’s great! Because the pods are coming from London, the insulin’s coming from West Virginia— we’re going to meet in the middle! And so we did, we ended up with a lot of pods. And a lot of insulin came. And so it worked out great.

And so we were really lucky. Within a day, we were able to start getting insulin out into the hands of the people who needed it.

[NARRATOR]: As you can probably guess, with donations coming in from all over like that, managing everything was a complex logistical operation. On the delivery end, there were lots of different people involved, and lots of moving parts. But also, with the flood destroying so much transportation infrastructure, getting around within the flood zone was dicey in many places, and near-impossible in others. And to make things even harder, many of the patients who needed help were cut off from communication. So they could be hard to find.

[MENDY]:  A lot of it was word-of-mouth. If I talked to one patient, and I knew that they were without insulin, I’m like, ‘Who else do you know that may need insulin?’ Just being out: house-to-house, home-to-home. That’s kind of how it all evolved. It was just, Mary made those calls and got stuff rolling, and then I started delivering.

Monday after flood is when the clinic [MCHC] was back in full swing. And we have another community health worker that works with us, too, and so we teamed up, and we just loaded our cars with food, and insulin, and monitor kits, and whatever we thought they would need, and kind of just went through the community handing out whatever, wherever we could get to.

A few places I couldn’t get to. A few places I shouldn’t have went!

[NARRATOR]: In their normal work-lives, Mary and Mendy just work with diabetics who are patients at MCHC. But in the weeks after the flood, they sort of just started helping everybody.

[MENDY]: A lot of times, I’ll be next door to somebody and as I go out the door or something, I’ll say, ‘Do you guys need anything?’ And that’ll start— ‘Yeah, I’m out of my medication, can you figure out how to do this?’ So, normally, we do just diabetic patients, but since the flood, we’ve been kind of doing checks on everybody that we can.

[MARY]: We’ve joked that we’ve adopted all the little Mamaws and Papaws.

[MENDY]: It’s been great, we’ve found homes that we didn’t know existed and people we didn’t know existed. And we’ve been able to help those people too, with a lot of times just food supplies, or whatever, not just their insulin.

[NARRATOR]: Mendy and Mary casting a wide net like this was a big deal, in part because health professionals would tell you that, even before the flood, one of the huge barriers to better health in east Kentucky was that a lot of people lacked reliable transportation. And there were many people—like customers of the Neon Pharmacy in Letcher County, for example—who relied on medication getting delivered to them.

[MENDY] Neon Pharmacy was a lot with my patients, because they delivered. So when Neon got flooded, there went their pharmacy. So, even if they didn’t get flooded, and even if they could get a hold of us, their pharmacy didn’t have the insulin. And they had no way of getting to us. So through those donations, we were able to take it out and say, ‘Here’s you a month’s worth of insulin.’

[NARRATOR]: When they step back and reflect on this whole effort, Mendy and Mary say  something special about it was just how many people reached out to help.

[MARY]: I had a patient who lost everything but came into the clinic to check on us, to see if we needed help. And I thought that’s just… that’s a prime example of our people.

[NARRATOR]: They also got donations not just from within the region, but also from all over the country.

[MARY] The farthest was California.

[MENDY] Yeah. We had some come from New York City. We said it was kind of like Christmas, because we had these Amazon boxes, that just came in with addresses on them. And we would kind of pass them around, there was four of us there, and each one of us would take a box, and open it, and see what we got today! I opened a box, and it was full of pumps, and I was like, ‘I don’t even know what this one is, Mary!’

But, you would be surprised how many people who have roots in Letcher County, or eastern Kentucky. And they all reached out. So it was just, like, word of mouth— everybody just started reaching out; families started reaching in. Because, you know, we always say, once you’re in the mountains, you’re always from the mountains. And so, they just started reaching out: ‘I have extra, what can I do to help?’

[NARRATOR]: At this point, of course, it’s been more than half a year since the flood. But when it comes to diabetes, people across the region are still dealing with different issues and disruptions the flood caused that have made managing blood sugar even harder. Like, maybe you lost your kitchen, or your whole house, and so your routine had to change, and you found yourself eating more fast food and processed food. Or maybe you’ve had to spend weeks, or months, working on your house, which also affected your diet or put strain on your body. Or maybe you’ve just been plain stressed. When we spoke to Mendy and Mary late last summer, they said all of this stuff can show up in your blood sugar.

[MENDY]: When you find out you’re a diabetic, it’s a huge lifestyle adjustment. So when you make that huge lifestyle adjustment, along with it comes some depression, some denial, some troubles in that area. And then, you add that flood in there, too— and so it’s been stress, and anxiety, and depression, and all that. And that’s something we’re going to have to work on, ongoing.

And a lot of mine who were doing what I considered very well for them, their blood sugars are going back up now. Or they’re getting what I call ‘wonky’ blood sugars— we’re dropping low when we didn’t have lows, or we’re going too high when we didn’t have highs. And a lot of that is the stress and worry from the flood. A couple of them lost everything they had in the flood. And so that’s something that I’m watching out for with the patients I see.

[NARRATOR]: Back in Hindman, Tedd Link felt that stress on his blood sugar first-hand. in the days and weeks after the flood, at his housing complex, Tedd was doing everything from delivering donated food to his neighbors to hauling water from a pond that was formed by a mudslide during the flood, so he and his neighbors could at least have water to flush their toilets.

[TEDD]: It was physically exhausting. It was twice a day delivering meals. And then some people dropped off canned goods— it was delivering the canned goods, separating the canned goods. Making sure everyone had equal amounts of everything. Going to the pond, getting pond water for everybody… it was physically too much for one person, but I was the only person that could do it.

[INTERVIEWER]: Were you feeling it in your blood sugar?

[TEDD]: Yeah. But I didn’t check it, though, because I didn’t want to know! (laughs) One day I did check it, and it was down to 70, and I was like, I literally said, I have to take a break. Because that’s dangerous, getting down to 70.

[NARRATOR]: But for Tedd, as stressful and difficult as the flood and its aftermath was, it might have led to something good, too. Remember Alice Caudill from the health department, who we heard back at the beginning of this story? When she found Tedd after the flood and told him his insulin was still okay to take, she realized there might be a need for diabetes education at Tedd’s Housing Complex. So, last fall, Alice put on a free class series about diabetes, for Tedd and all of his neighbors. Especially still being new to having diabetes, Tedd said he was excited to sign up.

[TEDD] I’m living in ignorance, kind of? You know what I mean, I don’t know what the high number is. I know, like, what the normal number should be around, and what the low number should be around. But don’t know when I should panic again, you know what I mean? (cut last part if resonance is still weird)

[NARRATOR]: And even though Tedd’s still learning about diabetes, one thing he already knows well is what it can do if you leave it unchecked. So, in setting the wheels for this class in motion, the flood might have actually, indirectly, led to something good for Tedd’s health, too.

[TEDD]: My sister had diabetes when she was pregnant. So I knew there was diabetes in the family. I found out my mom— she has diabetes, and she’s losing her eyesight from diabetes. And I’m worried I’m probably going to end up losing my eyesight. So that’s why I’m kind of like, I want to take this class. Because I want to learn about the diabetes, because, you know, I’m kind of young! (laughs) You know? Even though I am kind of old, I am still kind of young, you know what I mean, to lose my eyesight!

So, I mean, I know it’s important to get my diabetes under control.

[NARRATOR]: Reporting for WMMT, I’m Parker Hobson.