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Traveling with Diabetes
I truly love to travel, it’s one of the biggest passions in my life.
To get to see, feel, sense, experience and smell the smells of a new place, is sometimes what keeps me going through a rough patch.
I try to travel as often as I can, meaning as often as money allows me to. And although I’ve never pursued this passion without diabetes, it still makes sure to keep me on my toes.
Like the other week, when I was traveling back from Stockholm.
You know those low blood sugars that you do e v e r y t h i n g in your power to turn, but they just stubbornly hang on as if they were the ones in danger?
The ones that leave you in full panic mode, because what if your blood sugar doesn’t turn in time? What happens if you pass out and become unconscious?
Normally that’s not really an issue for me, my lows usually respond quite well and fast to my figured out and well-rehearsed treatment.
Just this particular low blood sugar wanted to stay with me. And stay and stay and stay.
So, for a little background info… Ever since I got my insulin pump, every time I fly I have to turn my basal rate WAY down. As in to -85% of the normal dose. It doesn’t matter when during the morning, day, night or evening I fly, unless I basically turn off the basal, I will invariably have a hypo.
The first couple of times when this happened I didn’t understand anything. I asked the company that manufactures my pump if, by any chance, high altitudes could influence it? Of course not was the answer, which was later also confirmed by my lovely diabetes nurse.
To this day I still don’t know why my blood sugar plummets as soon as I’m in the air. But that’s not the point of this story.
So, before this particular flight, my husband and I grabbed something small to eat before boarding the plane, because airplane food is beyond terrible and shouldn’t be eaten by anyone.
My blood sugar then was kind of highish, around 8 mmol/l (144 mg/dl), so I bloused a minor amount for the food, bearing in mind I had to turn down my basal rate anyway. It’s gonna work out, I reassured myself.
We boarded, I sat down, and turned down my basal before having to stow my bag in the overhead bin as we we’re seated by the emergency exit.
The take off was smooth considering the weather conditions. The fasten seatbelt light went off, and I went to grab my phone from my stowed bag to finish an audiobook I had on there. “Might as well take down the whole thing” I remember thinking.
Suddenly, I get a massive urge to just talk, talk, talk to my husband. This should have been my first sign that everything wasn’t right in the blood sugar department.
We talk about a future holiday and where we should go, when I suddenly get vertigo while sitting down in my seat. “Wooow, what’s going on?!”
I grabbed my Dexcom and saw it at 5.9 mmol/l (106 mg/dl) and sinking, fast.
“Oh shit.”
Basal was already basically turned off, so couldn’t do much more there. I grabbed a portion of glucose powder with 10 g carbs and chugged it, as I could feel how fast I was falling.
I waited the obligatory 10 minutes before checking both the Dexcom and manual blood sugar again. Dex said 4.5 mmol/ (81 mg/dl) and still falling. Manual check said 3.6 mmol/l (65 mg/dl).
“Fuck. What do I do?” I asked my rationally thinking better half.
“Have more glucose.” And I did. I had another 2 or 3 glucose tablets, munching on them like they were the lifeline I needed.
Considering my normal, total hypo correction is usually 4-8 grams of fast acting carbs, this was starting to worry me. I was up at more than double.
I was also running out of glucose tablets, as I barely ever need to use them anymore, I don’t carry an endless amount of them around anymore.
My darling husband called the flight attendant, asking her to quickly bring me some juice.
By the time the orange juice ran down my throat, I was in full-blown panic mode. Dexcom was still stubbornly pointing downwards.
This had now gone on for so long that my husband asked if they happened to have a Glucagon set in their onboard medicine kit, just in case. Of course, I hadn’t brought one with me. Why would I, I never need it and it’s one more thing for my poor back and shoulders to carry?
Turns out they didn’t have one. And even if they did, my husband, who has been brainwashed in how to use one of those things, wouldn’t have been allowed to administer it. It would have to be done by a medical professional.
As my blood sugar was still stubbornly going down, by this point at 2.4 mmol/l (43 mg/dl), I started to really panic.
Fast acting carbs were clearly not helping in time, there’s no Glucagon set and we still had 45 minutes until landing. If I pass out and lose consciousness now, I’m as good as dead. I don’t want to die here in an airplane, somewhere over Germany. Shit, piss, fuck.
I hear a flight attendant call out over the intercom: “One of our passengers is in need of immediate medical attention. Do we have any medical professionals on board?”
I had to laugh in the middle of my panic, that was a definite first for me. Very rarely have I needed to rely on complete strangers for help in treating a low blood sugar.
The most amazing thing was that on this flight of ca 200 passengers, there were 7 medical professionals. Seven, including a lovely doctor that kept me talking and drinking more orange juice.
The taste of the juice was so repulsive by this point. Eugh, how much I truly hated the taste of orange juice then. But it was my key back to life, so it was just to keep drinking it, especially as my blood sugar was still at 2.4 mmol/l (43 mg/dl).
After what seemed an eternity, panic, too many chalky glucose tablets and way too many glasses of yucky orange juice later, my new doctor friend told me to check my blood sugar again. 4.0 mmol/l (72 mg/dl) – thank all holy powers above, it was moving in the right direction!
By this point we were approaching landing, meaning I would have had to stow my hand luggage again. My husband kindly said that this wasn’t an option, and asked if they could re-seat us somewhere where I could keep my things right by m, in case things got ugly again.
Being a fully booked flight, the only option to re-seat us was in business class. I clearly didn’t care anymore at this point, I just wanted to land and get home to shower, have a hot tea and sleep. The other people in business class weren’t quite as understanding…
The last 20 minutes of the flight I got to sit in business class, which I had never done before. So, in order to lighten the mood, you could say diabetes got me upgraded for free. 🙂
Having buckled up for landing, I checked my blood sugar again. Seriously, my poor fingers. Anyway, it was 5.5 mmol/l (99 mg/dl) and I could finally breathe. Long, deep, oxygen filled breaths, which I hadn’t taken for the past hour or so.
Despite all the glucose and carbs I had had throughout this horror-hour, my blood sugar didn’t start to go up again until after leaving the plane. And it never went higher than 9.5 mmol/l (171 mg/dl), which was remarkable for that amount of carbs, which is guesstimated to be around the 60-80 gram mark.
My husband led me out from the plane on shaky legs, thanking the flight attendants for their amazing help and asking me if I was ok and if he should get me a wheel chair. Being mortified at the fact that diabetes caused me a scene, I told him I’d rather crawl to the exit than get in a wheel chair.
Getting home had never felt so good. Home where I was safe, and where I had Glucagon kits if I needed them. The day after was awful, I had the biggest hypo-hangover I’ve ever experienced, I was pretty much useless all day.
So, what’s my lesson in all this?
Even though everything turned out ok in the end this time, doesn’t mean it always will. I can’t even fly with active insulin from a previous meal, it has to be off. Completely. Also, always bring your own Glucagon. Airplanes don’t have them.
So, in light of this, let me share my 5 best traveling with diabetes tips with you:
- Figure out how YOU (and your blood sugar) react to air travel. Do you go high or low? Test, test, test and correct accordingly, either with food or with insulin.
- Wear something medical alert-y, whether that’s a piece of jewelry or a tattoo.
- Bring more supplies than you’d ever need for the same amount of time at home. It’s better to bring too much and not end up in the dark forests of Sweden without enough insulin… This includes hypo treatment. Bring L O T S of that. You just never know.
- Check your blood sugar more often. Is it going up or down? (This is especially where a CGM is truly worth its worth in gold (as they don’t weigh much…))
- Choose the pat down at security checks that use full body scanners (especially if you’re wearing medical equipment such as an insulin pump or CGM. You won’t get a new one if the scan damages your equipment.)
Although diabetes sometimes needs extra precautions before you set off, I would never ever stop flying and traveling. It’s one of the most amazing things in life, and all the extra work is worth it. You just need to find out how to counter-act it.
I would love to hear your travel tips, with or without diabetes – how do you make sure you stay healthy and well during travel?
New Year – New Resolutions?
“Working hard for something we don’t care about is called stress; working hard for something we love is called passion”
So why stress yourself to a goal you think you need and want?
I don’t believe in new years resolutions.
They are very often a surefire way of setting yourself up for failure.
Why is this?
There are many more or less valid reasons to why you don’t stick with your own promise to yourself.
I want to run through five of them with you today.
- You set goals you don’t want yourself.
Why, or, rather, for whom do you want to lose that weight?
For your partner to find you more attractive? For your kids? To keep up with the Joneses?
It’s all a damn lie.
If you don’t want it for yourself, and yourself exclusively, you are very unlikely to actually stick with it.
Ask yourself if the promise you made yourself last week actually is for your own sake or for someone elses.
FIX: Chose a resolution for YOU.
- You say the same old resolutions you did last year. And the year before. And the one before that.
“I want to lose weight, get healthy, organized, and save more money. This is my year, this year I’ll make it happen.”
Does that sound familiar? (Turns out that they are some of the most common new years resolutions, so technically, they should be familiar!)
Do they also happen to be the same ones you made last year?
Keeping up “appearances” in front of yourself is just a huge let down. Let’s face it; if you didn’t manage to make all of that happen last year, what says you’ll be able to do so this year?
Maybe something else is keeping you from creating your new life? More on that in the next point.
FIX: Ask yourself what you want NOW, for THIS year as the person you are TODAY and want to be in a year from now. What you wanted last year doesn’t matter. Anymore.
- You bite off more than you can chew.
Back to the example: “I want to lose weight, get healthy, organized, and save more money. This is my year, this year I’ll make it happen.”
Does that even sound realistic at all?
I know a year might seem like a huge chunk of time for you to get everything done and dusted. But if we’re real here for a second, we both know that that’s not the case.
Every day life gets in between your high hopes and promises to yourself, and all you end up doing is to stress and be disappointed in your seeming inability to make “any changes”.
You’re simply not giving yourself a chance!
FIX: Set realistic goals. What can you achieve within the next year? What do you want to achieve in the next year? Pick your number 1 on that list and stick to it. (If you manage to do more of them, awesome job!!)
- Your resolution isn’t focused enough.
If you’ve ever done any kind of coaching, or are at all into that sort of thing, you’ll have heard of SMART goals.
Goals that are Specific, Measurable, Achievable, Realistic and Timely are more likely to be reached.
And although this is a fantastic starting point of goal setting, there is one thing that is more important than the others: SPECIFIC.
If your goal isn’t specific enough, such as “I want to lose weight”, you never know when you’ve reached your goal.
If your goal, on the other hand, is specific, such as “I want to lose 5 kg until the trip I’m going on 20th February”, it’s a completely different thing.
Your brain registers it as a goal with a deadline that you have to make continuous effort to reach.
Do you see the difference?
You need to set your goal in a way that leaves you knowing exactly what you need to do next as a first step toward a healthier, happier, and better you.
FIX: Make sure your resolution is specific.
- You’re should-ing all over yourself
As in, if you don’t really want to make this change for yourself (see point 1), but feel you S H O U L D do it.
I’m sorry, game over, better luck next time.
If you say that you “should lose weight” instead of that you “want (really badly) to lose weight”, there’s a huge difference in how you, your body, brain and energy interpret that message.
A resolution that comes from guilt with an added side of stress and unhappiness for dessert will never work. And you should never say never.
It’s similar to that ever long to do list you have made for yourself that you know, deep down inside, you will never finish. Or want to finish either. It just creates too much anxiety, too much stress and too little fun!
FIX: Eliminate “should” from your resolution vocabulary. Or, better yet, altogether.
Your goals and resolutions ultimately have to make you happy, make your soul bubble and your heart shine.
Reviewing said goals and resolutions definitely should happen more than once a year as well. This is my biggest pet peeve with new years resolutions – once a year, on a more or less alcohol induced evening, you “have to” make promises for the next year.
That’s just weird!
Help is right around the corner though. And especially so if you’re in the Zürich (Switzerland) area!
If your (true) resolution is in any way health or fitness related, I’ve teamed up with two beyond excellent coaches to give you the best possible start of the new, healthier, happier, fitter and more productive you. Check us out here!
And, if you are in or around Zürich on the 17th January you have the exclusive chance to try us out and take us out for a test run! More details and to book your seat, click here!
Remember; resolutions are out, fun is in.
Lonely Diabetes?
Plus one is the loneliest number.
And my constant companion Diabetes knows exactly which buttons to push to make me feel lonely, alone and isolated.
It’s the time of family gatherings, meeting friends and spending time with those you love.
But if your (involuntary and unwanted) BFF Diabetes doesn’t play along, it doesn’t matter who else is around you.
This post is NOT about diabetes making you different from other people or that you have to things that are usually associated with being a drug addict, like shooting up and (sometimes) being paranoid.
It’s about feeling lonely although you have your best supporters, your true fan club, around you.
The other night, Dexter (my Dexcom CGM system) woke me up from my hazy sleep.
He had just buzzed 3 times, and because I wasn’t quite with it, I couldn’t remember what 3 buzzes meant – was I high or low?
I had only gone to bed 2 hours prior to this (quite rude) wake up call with a great blood sugar level, so I wondered which way it had gone wrong?
Dex said “LOW”, below 4.0 mmol/l (72 mg/l). I took out Doris (my OmniPod and trusted ally) and checked my blood sugar; 2.1 mmol/l (38 mg/l).
Nothing was making sense to me at this point; I was sweaty, my head fuzzy, I didn’t recognize where I was or what I had to do next.
I told myself I had a pretty low hypo for being me and that I needed to get to those glucose tabs faster than lightning, right after temporarily lowering the basal on my pump to -85%.
In my mind I gracefully climbed over my husband in the sofa bed we were sharing and jetted straight for my suitcase, where I had packed the glucose. (We were on a trip, staying with fantastic friends)
But in reality I was probably half-suffocating my husband, stumbling around like a local drunk and made more noise than I could ever realize.
Anyway. I sat down on the floor to eat some of the glucotabs. The slightly chalky texture and the acidy taste of them only intensified my symptoms.
During some of my lows I need something to chew on after the glucotabs, something that won’t help the hypo, as it otherwise overshoot. But just the feeling to keep chewing makes me feel safer in an unsafe situation.
I found, again in my mind very gracefully, a bar of 85% chocolate in my handbag, and started munching, instantly feeling a little bit better.
To I keep awake, I tried to play some simple games on my phone, none of which were making any sense to me. Playing cards, letters and colors were all a big mumbo jumbo, although it’s actually 3 separate games on my phone.
In this very moment I realized I was feeling really lonely.
This was despite having my husband snoring right next to me, and some other people sleeping in the same room. And I knew I could wake any of them up to keep me company and make sure I survived yet another hypo.
But I didn’t. Just because I’m not allowed to sleep right now, doesn’t mean others aren’t either, I thought to myself.
So I kept to my incoherent gaming, but couldn’t shake the feeling of being the loneliest person in the world in that moment.
As soon as I saw the number on my dexcom starting to go up, I put down my phone and went back to a hypo-sweat-drenched-sleep.
A few hours later, waking up with the biggest hypo-hangover ever, it made me feel lonely again.
I quickly resorted to some victim mentality thinking with thoughts like “why me?” And “no one understands me or what I’m going through or what it all feels like”, aka Loser-ville thoughts.
While I might have been right after yet another time with diabetes trying to kick my ass, I can’t forget what it has thought me about life.
A few of the useful and positive examples are: Being alone. Maths. Thicker skin. Acceptation. Pain. Fending for my life. Handling disappointment. That life is precious and frail. That I’m not invincible. Gratitude. Appreciation. Friendship. Health. Healing. Happiness. And, above all, the importance of Love.
Saffron Coconut Macaroons
I know just how busy you are today.
So today’s post will be very short and to the point.
A few people have asked me about the recipe for the Saffron Coconut Macaroons that I shared in my Diabetes Advent Calendar.
And because I’m feeling the festive spirits (no, I don’t mean the rum), I want to share it with you here on the blog today!
(If you don’t like saffron (gasp!), they’re absolutely delicious if you leave it out, too)
Saffron Coconut Macaroons
Makes about 10
You’ll need:
25 g butter
1 egg
1.5 dl (0.6 cups) desiccated coconut
1 tbsp. stevia or agave (or honey, if you can take it)
1 pinch vanilla powder
1 packet saffron
Do this:
Put the oven on 175 degrees.
Melt the butter with the saffron.
Whisk together the egg and sweetener of your choice.
Add all the other ingredients to the mix.
Let the mix rest for a few minutes.
Make “peaks” on a baking sheet and bake in the oven for 10-15 minutes, until the tops are golden brown.
Each peak has 4 grams of carbohydrate.
Saffron Coconut Macaroons
These yummy treats are gluten-, grain-, treenut-, soy- and (almost) sugar free, so they suit most people.
Let me know how yours turned out in the comments below!
ENJOY!
Doctor’s Praise
Have you ever had a doctor’s appointment during which you get praise from said doctor?
This was a completely foreign concept for me until recently, despite having lived with Type 1 Diabetes for 29 years.
But as I’ve managed to gain better insight into the illness that co-habits my body, and therefore slightly better control, there have been more and more positive encouragement coming form my health team.
Just a couple of years ago, I would always be scared of going to the doctors, any doctor I have (and I have a few).
Scared of the results, scared of what they might find this time.
Scared of being told off, scared of being disappointed in myself.
Scared of being hurt and a failure. Scared of the amount of work that lay ahead of me.
Because that’s what it had been like all my life.
Every doctors appointment until recently, had been one of disappointment, hurt, even tears, and after, not-being-bothered – because why bother if I always get the same sh*t shoved at me by the doctors?
Let’s not turn this into too much of a sobby victim story though.
About a year ago, when I had finished the education for my pump with my lovely diabetes educator, she told me I was one of her best patients.
After having grown up with the notion that doctors (and nurses) are equal to the evil spawn of something ugly, I was stunned for a second.
And then filled with love. Love, gratitude, and appreciation.
Not necessarily for diabetes, but rather for the advancements I had made by that point.
It was probably my first (and to this day, only) time I’ve performed a little one-man boogie in a doctor’s office.
It’s incredibly what a little doctor’s praise can do!
It spurs you on, keeps you going and at least it helps me when the going gets extra tough (which it inevitably does, considering it’s diabetes we’re talking about.)
And then today (aka the-second-time-my-jaw-dropped-through-the floor-at-my-doctor’s-office), at my check up, my doctor goes to me: “you’re one of my best patients. You seem much more relaxed about diabetes now than when I first met you.”
Wait? Did I hear that correctly?
My immediate reaction was to ask if she could put it in writing. She answered that she would if I really wanted her to.
To the point: yes. That might very well be true that I am, as I don’t know a single of her other patients. And I’m super grateful that I’ve managed to get to where I am today.
But I don’t think she has any idea of just how much work I’ve put into gaining this clarity I now have of diabetes. Which doesn’t, by any means, I’m anywhere near full understanding of it. It just means that I’ve made some progress in the recent years.
A few examples:
I’ve had to say no to things I really wanted to do because my blood sugar wasn’t cooperating.
There have been some late nights…
,,,,and early mornings…
…including wake ups in the middle of the night.
A copious and endless amount of (painful) finger pricks, injections, pump site insertions and CGM sensor insertions.
Carrying medical equipment around, big handbags have been of benefit. My shoulders and neck muscles do not agree.
Snacks, snacks and more snacks.
A huge part has been the mental work I’ve done. Truly coming to terms with diabetes is not an easy task, and is usually completely overlooked by the medical community. I’ve meditated for hours, and now I notice a difference in my blood sugars when I don’t do it! Stress is closely linked to blood sugars, so it’s really important to find ways to release stress. A newer tool I’ve been using is EFT tapping to try to get past the bigger concerns regarding diabetes.
Eating well and according to diabetes, which, for me, means very low carb.
Having to play my own pancreas. On the outside. With zero communication from the other organs that play a part, like the liver, for example.
Drinking lots of water. I’d be so rich if I had a penny for every liter of water I’ve drank!
Exercising and trying to figure out how it works. Sometimes exercise makes my blood sugar high, sometimes low, sometimes the same and sometimes the effect doesn’t come until 12 hours later (depending on how strenuous the exercise was). What on earth do I do with my basal settings?!
Speaking of which, figuring out everyday things like flights, how to eat on the road, restaurants, walking too much (and at irregular times!), drinking alcohol, combining an outfit to fit medical devices as well as how to solve the caffeine question, have all been part of the journey so far.
And that’s just to say what it has taken so far. It definitely doesn’t mean that it will always stay the same. Diabetes is a very dynamic and constantly ever-changing partner to have by your side.
But, this is where it really pays off to have a carefully selected and well-researched health team.
Because even if they don’t know exactly what you’re going through, they’re willing to understand and make arrangements for you.
Oh, yeah, my A1C? 6.4% today.