(Almost) Up in the Air

How many OmniPods would you take on a ten day vacation?

If you were going to leave your home early one morning and drive over an hour to an airport to catch a four hour flight, one that would take you to a remote island location for ten days... how may OmniPods would you bring?

I brought eleven

I also brought two hundred test strips, an extra MultiClix, an entire package of lancet cartridges, one backup OmniPod PDM, a ketone meter with a 50 strips, two glucogon kits, four vials of Apidra, five DexCom sensors, a brick of juice boxes, candy, fast acting glucose tablets, five packages of needles, FlexiFix, AAA batteries, a DexCom charger and three copies of the travel letter that our endo wrote.

Other than the fact that everyone was a mix of exhausted (long year) and excited (we never go on vacations like this), our flight to the Caribbean was uneventful. The TSA experience in New York was fast, pleasant and so accommodating that the multiple juice boxes we brought through screening were treated like medication. Actually, for the first nine and a half days of this vacation all of my extra supply preparation was unnecessary. We never had one issue with our D technology, sensors stayed on, insulin resisted the heat and diabetes was a perfectly behaved travel partner.

It wasn't until we were literally walking out of the door to return home from our island getaway that things began to go the other way. I knew that the odds were stacked against us, I mean, how often do you get to go ten days without a significant diabetes issue that requires your inner MacGyver?

During travel, I keep enough supplies in my carry on bag to complete one site change. The bag also contains enough insulin and needles to manage for a full day without needing the backup supplies that are in my larger luggage. I lug that stuff with me when we fly with the hopes that I'll never need it.

Was it an omen, probably not... I don't believe in omens, but I did drop a vial of insulin as I was packaging the Apidra back into it's ice pack for the trip home. Fun Fact: I've never broken a vial of insulin until the one in my hand hit the stone floor of our rental home. No matter, I had three more. #prepared

We drove our rental jeep to the ferry, made the short trip from island to island and then jumped into a taxi destine for the airport. It was during that taxi ride that Arden's BG got a little squirrelly, I bolused. TSA was again a dream and before we knew it our bags were off to the belly of the plane. All that was left to do was to grab a pre-flight meal and wait to board. We ate, found our way to the correct gate and planted ourselves in some soft chairs. 

Ferry Departure

BEEP BEEP goes the DexCom

"I must have miscalculated the airport food", that's what I thought when Arden's CGM indicated that her BG was rising thirty minutes after our meal. I reassessed and added more insulin but the beeping continued, soon after the arrows changed from diagonal up to one arrow straight up. Before long, the arrow found a friend... two arrows up. Hmmm, WTF!? Turns out that Arden must have unknowingly banged her leg into something during our trip from paradise to the airport, I noticed a tear on the OmniPod adhesive and the canula looked withdrawn. Interestingly, on the same day that I dropped my first vial of insulin our first canula became dislodged. What a diabetes day we were having, I wonder what could make it even odder? How about my first airport pod change at gate 4. Honestly, it didn't bother me to change the pod there and Arden didn't care... she isn't shy about diabetes in public. So I balanced everything on my lap and set what didn't fit on my leg behind Kelly on the chair next to me. I filled the pod, primed, inserted and removed the old device in a few moments. We tested, increased Arden's basal rate and then busted out a good ole' fashioned needle to combat her wildly high BG of 425. 

I'll admit that I was a bit panicky for a moment, the notion of chasing this high number in the air dind't sit well but then I remembered that we had a full complement of juice and other items. I did experience a wave of dread as I used the only spare pod that I had in my carry on bag. I began to run through scenarios in my mind, how I could talk TSA into retrieving my luggage from the plane so I could get more? But then I calmed down, we boarded the island way (see pic at top) and a number of hours later we landed at JFK airport where Arden's BG was 113. Seems Ben Franklin was correct, An ounce of prevention is worth a pound of cure. Smart guy. I may not be Franklin but I know this for sure... Bring extra supplies when you travel, you never know what may happen.

Luckily, we can only afford to go on a trip like this once a decade, so I have time to rest and recover!

Finally, here are some obligatory vacation photos.

Fear can look like a bus

How do you hand your child over to a stranger?  Even when there is no medical issue, sending your kids to school is a stressful thing to go through.  I always use the bus as an example.  We spent countless hours researching car seats and painstakingly strapped our kids into them.  We spent extra thousands of dollars on a car with a better crash rating and then one day we just ignored all of that and pushed our son onto a 14 ton bus with an elderly man that I never met before and waved goodbye.  Anyway you slice it, that’s not so smart.  Now I’m no paranoid and I love that my children are growing more and more independent with everyday.  In fact I understand and welcome the lessons that they will learn when they are away from us and I know that in all likelihood their bus will never be in an accident.  So I put Cole on that bus... but Cole isn’t in any reasonable risk of experiencing a dire medical emergency, Arden is.

So, Fear #1 - I’m afraid of the bus.

How did I make that fear go away? I didn’t but I did dwell it quite a bit.  First thing I did was not take my first option which was to request in Arden’s 504 plan that we be provided with a smaller, air conditioned bus with a medical aide on it.  I could have and I’d have been well within my right to do so but I don’t want that to be Arden’s experience.  I want her school days to be as normal as possible.  So I contacted the transportation department and explained Arden’s situation and we were able to adjust the bus route so that she is the last one on and the first one off.  Her bus time is as limited as possible and I think that with the nurses help we can keep Arden’s insulin peaks away from her travel time.  Additionally, the bus company found us a more empathetic then normal driver.  A very nice woman who isn’t put off by the diabetes or by the extra responsibility that we’ve unfairly asked her to shoulder.

Sadly, all of the planning in the world can’t avoid a low BG incident forever, so Arden has a cell phone and an emergency kit with food, juice and fast acting glucose.  She knows to eat and drink if she feels strange and the driver has been instructed to let her do so.  We’ve also given the driver information on how to access Arden visually and a plan for what to do in an emergency. 

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The following are archived comments from this post. You can post new comments below.

Anonymous

Hi,
I'm sure Arden will do well.  I'm excited to hear she has a pump now.  Just wanted to say hello!!!  She is getting so big.
Best of luck in school Arden.
Miss you guys.
Sakeenah Boyd, NP (former Diabetes Nurse Practitioner)

Monday, September 21, 2009 - 09:12 PM