Being so immersed in both own life with T1, and the diabetes community-at-large, I sometimes forget that "the rest of the world" isn't in on lingo I use, or the schedule I keep. The people in my inner circle are pretty knowledgable about what goes into my diabetes care. I guess, because of this, I forget that anyone else I might encounter could know little (or nothing) about type 1 diabetes - or any kind of diabetes, for that matter. I do my best to educate as I go.
Here's a rundown of things I encountered during my travel and vacation:
Flying stresses me out. Okay, maybe this isn't news - I have always been apprehensive about flying. Not the actual being-on-a-plane, holy-cow-this-is-really-high-up stuff, but the parts where I wonder, "Did I bring enough glucose test strips?", or "How much of a hassle is it going to be getting through the TSA checkpoint this time?", or better yet, "What if my insulin pump, or any other piece of equipment, decides to fail while I'm away from home?". What this means is that I carry a lot of stuff with me when I fly. As my husband noticed, my carry-on bag is 90% diabetic supplies, and I'm lucky to get a book and a jacket stuffed in there with them. There are so many things that could go wrong, and I have to plan for every single one of them. For example, my checked baggage could be lost - which explains why I carry all of my supplies with me. This trip, I completely filled two gallon-size plastic bags, plus a smaller cosmetic bag. Here's what I brought:
- a box of alcohol swabs (quantity 100)
- 250 test strips (much more than for 5 days - what if my return flight got cancelled, and I was stuck there an extra day?)
- a glucagon kit (what if I went low during my sleep, and my friend couldn't get me to wake up to drink juice or eat glucose tabs? This is an emergency-only option, but you never know when emergencies will happen. And, you can sure bet that they'll happen at the time you're least prepared for them.)
- IV Prep antiseptic wipes for insulin pump infusion sites, and CGM sites (brought twice as many as I thought I'd use)
- two boxes each of two types of insulin pens (what if my insulin pump died? It's happened to me before!)
- one box of insulin pen needles (quantity 100 - so, about twice as much as I thought I'd use, if the pump broke on my first day there)
- two vials of Humalog insulin (what I use in my insulin pump, to refill it every two-ish days)
- 7 insulin pump infusion sets (which is also twice as many as I'd normally use. But - what if I accidentally pull out my site? What if I do it more than once? What if my sites clog up more quickly than I'm used to?)
- 7 insulin pump cartridges (see above.)
- a jug of glucose tabs
- my glucose meter
- extra lancets for finger sticks
All of these items, according to the TSA, need to have prescription labels in tact. Some will tell you that you also need a doctor's note explaining why you need to have all of these things with you, but I've never had to show one. (This always seemed absurd to me. Who is going to carry around such expensive medical supplies unnecessarily?) So, for some, I cut off the label from the box and stuck it loose in the bag.
Sometimes, the TSA is cool. At the airport in Omaha, I had a generally good experience going through security. I took all of my healthcare stuff out and asked for it to be hand-checked. (Some things, like a glucose meter and test strips, are sensitive to x-ray, so it's best to have them not go through the scanner. I tend to pack everything together, so I just have it all hand-checked - which I figure is safer, anyway.) Took off my shoes, waited my turn, and went through the scanner. BEEEEP! Back up. Let's see, what do I have on me? Usually insulin pumps hadn't set off the alarm at airports for me before, but I went ahead and told the guy about it. He had me wait for a female TSA agent, who was a friendly lady not much older than I am. She had to do the full body check with a wand, and also pat down some parts to be sure. She kept apologizing, and was very cool about the whole thing. She found my insulin pump, and the CGM sensor on my abdomen, and asked me several questions about them. I was glad I had an opportunity to educate! After a couple of minutes, we were done, my supplies were checked, and I was on my way. Piece of cake!
Sometimes, the TSA doesn't know what a piece of cake is. The experience I had in Hartford couldn't have been more different. As I pointed to my plastic bags and asked for a hand-check, the lady behind the conveyor belt told me "Those don't need to be hand-checked." Um, excuse me? I again made my request. Her rebuttal: "My boyfriend is diabetic, and all of his stuff goes through the scanner." Me: "Well, mine can't. Some of the things in there are sensitive to x-rays." Her: "Which things? His go through just fine." Me: "The test strips, and..." Her: "No, those don't need to be pulled out." This is where I just about lost it. I spoke as slowly and clearly as I could, enunciating every syllable, hopefully without sounding outright derogatory. "I would really feel more comfortable if they got hand-checked." So, what she did was pull out only the test strips (as she didn't let me finish my sentence to include "...and my glucose meter.") and shoved the rest of it through the x-ray. And now? My meter screen has two permanent lines going across the screen, that weren't there before. At least I didn't have to get wanded again - in fact, I didn't even set off their alarm going through the scanner.
Being associated with a Jonas Brother is okay. Some of my friend's friends were gathered on Friday night at her house. I hadn't met these people before, and it appeared my friend hadn't said anything about my faulty pancreas - which is totally fine. So, when I kept fiddling with my pump and CGM receiver, I had some noticing glances. I mentioned I had type 1 diabetes, and the room lit up. "Is that where you can't eat salt, or sugar?" was the most surprising one to me - I thought that understanding was pretty commonplace. My favorite comment was, "Isn't that what that Jonas Brother has?" I think I actually shrieked. "YES!!! That's exactly what I have!" I was so grateful, that in that moment, at least one person knew exactly what I was talking about. I feel grateful that Nick has been spreading awareness of the condition we share, so that at least there was one less time in my life that I'll have to explain exactly what type of diabetic I am.
Vacation stress = much less insulin. I had always thought that stress made my glucose levels rise, because of the hormones that get released during stress and anxiety. As it turns out, at least for stress related to travel, my numbers drop. I had to set a temporary basal rate of -50% of my normal rates for pretty much the entire day, on both days I flew. And I had great numbers after that. I couldn't believe it!
An insulin pump clipped to your swimsuit really isn't a big deal. Here I was, all paranoid about wearing it clipped to my suit, and really - no one noticed. I kept looking around, but I never caught anyone staring. (If I were a more narcassistic woman, I might have been bothered by this. As things were, I was just fine with it.) The pump stayed in the shade most of the day, and it all worked out just fine, being attached to me the whole day.
In short, it was a great trip, and was exactly what I needed. Even though T1 can make travelling even more stressful than it already is, it's worth it - and can be done without much trouble. :)