A little while ago, I needed a change. Feeling mentally burnt out, I decided to take a month off from work and in that time, complete an epic 800km walk called the Camino de Santiago. Also known as the Way of St. James, the Camino de Santiago is a pilgrimage of medieval origin, journeying from France and across the Pyrenees to the Cathedral of Santiago de Compostela in Spain’s northwestern region. My grandmother was actually born in Galician, where the trek traditionally ends, and I’d always had an interest in the country with family still living there. I’d been learning Spanish for a few years by that point and really liked the food and culture.
A few months before I left, I briefly spoke to my rheumatologist about the trip while at a check-up. Funnily enough, there was a trainee doctor in with my consultant who’d done the camino himself! He said it was a great experience and overall, my medical team was pretty supportive. We talked about taking the walk at my own pace, not pushing myself and being conscious of my limits.
With hindsight, I wish I’d taken this advice more seriously.
800km to go
I was determined to do the full pilgrimage in four weeks. Some people spread it out over a number of trips, or split it up to see different parts of the route at different times of the year, but I didn’t want to keep going back and forth. Part of the appeal was that you don’t need to plan ahead – you just turn up and walk at your own pace, following the routes you choose from a guidebook and stop whenever and wherever you feel like it.
At the time, my arthritis was well-controlled with methotrexate and etanercept and I’d practiced walking long distances – I thought it would be fine. I was looking forward to visiting lots of new places and staying in the albergues (a kind of hostel), meeting other pilgrims and emptying my head of everything that had mentally worn me out.
Managing medications abroad
Some time before leaving for the trip, I switched from methotrexate injection to tablet form. Taking up less space, I figured tablets would be easier for travelling and although I had worse side effects, I intended to plan a rest day after taking the weekly medication. It didn’t always turn out that way – I probably should have done more of that, looking back!
The way I approached my biologic was more reckless, which I regret. Being an injection that has to be stored at specific temperatures, needing sharps bins and knowing I should have talked to my consultant about it, I convinced myself it was too complicated to bring on the camino. Instead, I had one injection when I left home and another on my return.
I should have been more upfront about my plans at my rheumatology appointment – especially around what I intended to do about my medication while away, and the length of time I wanted to finish the walk in. I avoided the difficult conversation because I worried what the doctor would say. I had my mind set on this pilgrimage and didn’t want to risk anything stalling it. This wasn’t my best idea. Being more open and getting advice about my medication is definitely on my list of things to do differently in future.
Keeping up
My biggest mistake with the camino was trying to keep up with people and groups I met along the way. They’d often walk further and faster than I should have, but in that situation it’s difficult because you want to keep pace. Sometimes, I was the youngest by quite a bit – it felt like I should be able to match the pace of pilgrims much older than me!
I’m generally quite a private person. Although I did mention my arthritis occasionally, it isn’t something I brought up much. There was a period when I felt unwell, probably from pushing myself too hard, but also just feeling run down from staying in hostels with loads of other people, and I ended up asking to stay on longer at an albergue in a tiny village. I needed to rest for a few days and not long after, diverted from the camino to tie-in a family visit.
As I’d walked three-quarters of the route, I extended my break to spend time with relatives and decided to call a stop to my pilgrimage there. I plan to go back to finish those last 200km and next time, I’ll be more determined to keep my own pace.
A great experience
Pilgrims can be quite open about themselves during the walk. They might be doing it for a cathartic experience or religious reasons, and some see it as an opportunity to sort the stuff out in life they need to. The camino wasn’t what I expected in every respect – I mean, it’s not like you can do this one thing and it’ll fix all life’s problems! It doesn’t work like that, but I learned some interesting things, met all sorts of people from all over the world and saw so many great places. I really loved it.
It’s a fairly cheap way of seeing northern Spain too. The alburgues are only 8-12 Euros a night and most places do special pilgrim menus, meaning you can get a pretty good meal each day for a reasonable price – that’s with wine as well, although I didn’t indulge because of the methotrexate! You could easily budget for 30-40 Euros a day I reckon.
The last leg
When I finish my camino, I think I’ll actually get more out of it because of the mistakes I made the first time around. Experiences I learnt from that I wouldn’t have known about – like how to ease painful blisters – will make it more enjoyable and I now understand how to prepare better in an arthritis sense.
I thought I was quite fit before the last trip, as I do a lot of tai chi and swimming but you don’t realise what your limits are until you’re walking everyday. I’ll work up my walking in the weeks beforehand and likely spread the remaining distance over a fortnight. I know setting my own pace is essential and I’ll be taking my medication more seriously by having proper conversations with the appropriate professionals. Lesson learned.
DISCLAIMER:
If you aspire to undertake something similar to Sean’s challenging adventure, you should have a chat with your rheumatology team well in advance to let them help you plan and work towards your mental and physical fitness. There are also options on how to store medication safely for travel, so worth speaking to your Rheumatology nurse to see whats possible.
