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Tuesday 28 February 2017

No Pumps On Board

I don't know if I would call myself a regular airport attendee, but between work and spending money that my bank would rather I didn't on holidays, I have developed a well-versed diabetes travel routine. It doesn't give me optimal control all the time, but I do the best I can. Travel days are always going to be something that throws me, because they throw my body out. Different wake and sleep times, less activity, more sitting and the food routine and diet changes wreck havoc on my best-laid plans.

Travel with a medical condition like diabetes can be scary, exhausting, busy and burdening. Plane journeys are uncomfortable enough without the added feelings of a low or high blood sugar or having airport security fussing over your medical condition.

Before any travel (especially international), I always make sure I am well-stocked with supplies and that they are packed in an easy to reach place on my onboard luggage. I never put any diabetes supplies below in checked luggage because I can't guarantee I will get my bag on the other side or that nothing will happen to my bag (such as sudden temperature changes or rough handling). If I'm travelling international I split my supplies between my husband and myself. I take about 30% more supplies than what I need as a precaution. Last time we went to Japan (In 2013) that 30% extra insulin probably saved me a trip to a pharmacy to get more bottles of life because the heat in Japan was causing my insulin to expire every 1.5 days.

I bought some of those packing cubes a while ago, and I found that the smaller ones are perfect to put all my supplies in. It makes it super easy at security and on the plane/travelling around if everything you need is in one spot.

NO PUMPS ON BOARD: Saw this on my recent flight to Sapporo on the flight safety card. The 'not permitted' symbol seems to include an insulin pump. ???

As well as supplies, my number one recommended thing to take with me is my scripts and a letter from my doctor, explaining what each item that I carry is and what it is used for. I also make sure the doctor's note explains why my pump cant go through any screening such as MRI, CT or X-Ray. I have used this letter in Japan every time without fail as Insulin pumps are not common in Japan. In Sapporo, they were insistent that I turn my back-up pump on to make sure it wasn't an explosive device. I had to unscrew the battery compartment to show them that it wasn't possible for me to turn it on, if there was nothing to power it and then they ran the bomb swab over the pump which was fine. In Cairns I whipped out my trusty letter to avoid the full body scanner, which I went through last time by removing my pump, but was not possible this time because of the newly inserted CGM taped securely to my arm.

I don't usually display my pump, and will normally hide it underneath my jumper, to avoid unnecessary questions from security. The few times that I have had it out, it has caused issues. Luckily, my Medtronic pump does not set off the metal detectors, so hiding the pump beneath my clothes is easy.

For domestic flights, I can take juice or other liquids through security, but for International, I try to stock up on glucose tabs in case of a hypo in the security line. I always buy a sugary drink once through security, but in some countries like Indonesia, they actually make you throw out any liquids before you can board the plane, so anything purchased after clearing security is a waste.

At take-off and landing, I disconnect my pump, otherwise changes in air pressure push extra insulin through my cannula and I get very low, very fast.

Most recently, I have been disobeying the rules regarding transmitter devices on planes, and have kept my CGM on during all my flights for the past year (over 20 flights). The plane hasn't crashed, or lost its course, and my pump hasn't exploded. Its made flying so much easier, especially on long-haul flights, where my husband can now just check my pump to see what my BGLs are doing instead of waking me up. I can also see any problems I am having and fix them up far quicker than if I had the CGM turned off and was only doing manual checks once every 2 or 3 hours. Especially when landing, I can see if I need to have some sugar to avoid a baggage claim low.

All of these preparations means that the biggest issue I have with travelling with diabetes, is that I have diabetes. Today, for example, I got on a plane to Sydney at 9am in the morning. Then I got on the return flight home at 3pm in the afternoon. One flight went well for my diabetes, one flight did not. I did the same thing on both flights. The morning flight went well because I had been able to follow a similar routine to my normal day. I ate breakfast, got on the morning flight (when I would normally be sitting at my desk) and BGLs tracked between 4 - 6. The afternoon flight did not go so well because I had missed my 20 minute lunchtime walk, missed morning tea, delayed lunch by 2 hours, and eaten different food to normal for lunch. If only I could have left diabetes at home by itself for the day.

Tuesday 7 February 2017

Position Vacant

SCENE ONE

ASHLEIGH staggers into an over-bright boardroom in a workplace office. Furnished with a long board table, and many wheel-footed office chairs. Ashleigh flops into a chair at the far-end of the table. She is sucking on a straw plunged through a juice popper. 'B'sits beside Ashleigh. 12 OTHER COLLEAGUES take seats around the room.

ALL (singing): 
Happy Birthday to you, Happy Birthday to you. 
Happy birthday dear colleague, happy birthday to you.

Ashleigh waits until the singing has stopped and lowers her forehead to the table.

COLLEAGUE 1 (to Ashleigh):
Are you alright?

COLLEAGUE 2:
Are you sick? What happened? Are you ok?

COLLEAGUE 3:
Oh yeah, you don't look too good. Are you right?

Colleagues continue firing questions. Ashleigh makes vague grumbling noises, raises her juice and makes shooing motions with her hands.

B:
She's fine. Just leave her alone. She's just having a
low blood sugar.

COLLEAGUE 3:
Do you need us to get you anything?

COLLEAGUE 1:
Ohhhh, I'll get the Glucagon! Can I give you a shot?

B:
She's got her juice. She'll be fine. Just give her a few minutes.

COLLEAGUE 1:
Why can't we use the Glucagon?

ASHLEIGH (with some energy now):
I have a juice. I just need quiet for a few minutes. You can't use 
the Glucagon unless its an emergency; only if I'm unconscious or 
can't have sugar. 

END SCENE




When you have a self-management  heavy disease like diabetes its important that you have a few people around you like S who are on your side in your day to day life. There's a lot to diabetes.

It takes a lot of time, energy and effort to train a Diabetes side kick. You work at educating them over many months, maybe even years. Slowly feeding information through small conversations or simple statements. Whether you mean to or not with these people, you create a relationship with them that involves some amount of diabetes knowledge download.

So I have people. I have friends who I knew before I was diagnosed, who picked it up as we went along. I have family who I expect a lot of. I have diabuddies who I don't need to explain at all to. I have a work colleague. Change that to had, because S will be finishing up her job with my workplace at the end of this week.

I have to start fending for myself again at work. Its helpful having someone who knows your diabetes in situations like the birthday cake hypo debacle. (Which continued on past the initial hypo. I had people asking me days later if I was 'feeling better yet' which really confused me because I didn't remember taking any sick leave or feeling ill. I had to be reminded of 'the other day in the boardroom at morning tea'.)

Its impossible to spread the knowledge among too many people, so if you can have one or two people that know enough about what is an emergency, what a hypo is and when everyone else should leave you alone and stop talking, then you're doing alright.

Goodbye to my work diabetes look-out. I'll never train another quite like you. Thank you for never talking to me when I'm hypo. not stabbing me unnecessarily with the Glucagon, not judging, bothering to listen to my diabetes natter, and all the jaunts down the road to stock up on juice when I ran out.