Monday, March 3, 2014

Vacationing with Diabetes

Having just returned from vacation, I would normally be sharing the highlights of the trip.  But I'll save that for other social media.  Here on the blog, I want to discuss the experience of taking Diabetes along with us on vacation.

You see, Diabetes doesn't just visit us occasionally, he barged into our lives 10 years ago and will not go away.  Our vacation prep started by trying to pack and tie up loose ends, but also included shelling out big bucks to make sure we had supplies to manage the kids' diabetes while on the road: extra insulin pods, extra insulin, syringes, test strips, glucagon shots, ketone strips, juice boxes and skittles and PB crackers for lows... 

Once all that was taken care of, we loaded up and started on our trip.  On the second day of the trip, we hit our first bump in the road: apparently, of all the extra insulin pods (Omnipods, the brand of pump we use), we apparently had over half of them from a bad lot which kept failing.  We usually change pods every three days.  Planning on being gone 9 days, that means, at minimum we needed 3 pods per kid, or 6 pods.  We packed 15.  By day two, we had already run through four pods because they kept failing, requiring us to discard the malfunctioning pods and apply new ones.

Traveling means long stretches of inactivity while riding in the car, coupled with boredom and a lack of healthy snack foods means we typically have higher BGs when on the road.  That is not usually a big deal, as we compensate for it with insulin intake and extra BG checks.  However, on this trip, we were fighting blood glucose lows instead of highs.  We went through lots of juice boxes and snacks and had to be extra vigilant for the first leg of our trip.

Our Service Dog, Sherly, at the Grand Canyon
Sherly watches over the kids as they explore the Grand Canyon
After our first long day of travel, we spent day two at the Grand Canyon.  It was breathtaking.  It was amazing.  It was a place where memories were made.  Of course, diabetes wanted to make some memories, too.  After being cooped up in the car, the previous day, diabetes came with us as we hiked along the South Rim.  I wish we could have just enjoyed the view, but we had to stop every couple of hours and make sure the kids' BG were in range.  All in all, it wasn't such a bad BG day though.

Day three at the Hoover Dam was a blast, but keeping up with supplies and keeping the kids' kits stocked was a challenge, because we were burning through juice boxes.  Turns out, while Amelia, MH and I were touring the visitor's center, we got a call from our traveling companions that Ethan had left his glucometer in the car, which was parked in the parking structure.  Not an insurmountable challenge, but it highlights one of our challenges.  If he had left his wallet or his camera, we would have said something like, "Oh, well.  You need to learn to keep up with your things, mister."  But we cannot NOT go get his glucometer/controller for his pump.  I want to point out that 90% of the time, both kids are very responsible with keeping up with their kits, but those 10% when they forget, it is almost always inconvenient.
We drove from Hoover Dam to Las Vegas to have dinner on the strip and got to see some amazing things, like the fountain in front of the Bellagio and costumed vendors hawking photo opportunities for "tips" (I'm sorry, but the standard tip is $5, sir...)  On our hike up and down the Strip, MH had a low and we discovered that neither of them had restocked their kits with extra juice or crackers, but we managed (this will be a theme for the rest of the trip).

The next morning, we got up and made ready to travel to the end of route 66: The Santa Monica pier!  But before we left, we needed to change MH's pod and... you guessed it...old pod off and two pod failures from the bad lot means three more pods unusable.  We are now three days in and we've gone through half our pods.  The rest of the drive to the coast was scenic as outside we saw the environment change from desert to mountain to coastal plains.  We spent the rest of the day playing in the Pacific and on the pier.  It was fantastic. 

One of the side effects of traveling, we discovered, was the stress it adds to an already stressed out Diabetic Alert Dog.  Aside from having her routine interrupted and rollercoaster BGs with the kids, she didn't eat very well and developed an upset stomach.  Sherly started exhibiting signs of distress and we ended up having to take her to the vet the morning we were supposed to head to Disneyland.  We ended up letting her stay at the vet the first day, but it put us a couple of hours late.  Then, after only one ride, we stopped to check BG and Ethan's pod failed.  And then the spare he brought with him failed.  And MH didn't restock her kit from the day before so we had ZERO pods and ZERO extra supplies.  So, Ethan and I left the park and went back to the house where we were staying to gear up and restock.  That put us back to Disneyland at about 2pm, having only experienced the parking facility and Cars Land (in California Adventures).  The rest of the day went by without a significant incident until, at the end of the day, when we were watching the Wonderful World of Color, Ethan started crying.  I asked him if everything was okay and he made some nonsense reply and I immediately sat him down to check his BG: he was low.  Luckily, we had supplies, so we quickly recovered and enjoyed the rest of the show.  

I won't bore you with the minute by minute details of how diabetes follows us around and makes us jump through hoops, but the following pictures are typical of every couple of hours (or sooner), we would have to stop what we were doing and make sure that the kids weren't about to get sick from high BG or pass out from low BG. 

After all the pod failures, we panicked a little and had the Endocrinology team at OU call in some Lantus and backup supplies to a Wal-Green's in Anaheim.  We figured that at the rate we were going through pods and supplies, we had better have backup in case we ran out and had to revert to using Lantus and Novalog injections.  Unfortunately, with it being the beginning of the year and our deductible not met yet, that set us back another $1,000.  OUCH!

I guess the only other big event that happened was our 2nd day at Disney, we had extra supplies in Amelia's backpack and had even had Ethan repack his kit so we could use the backpack for extra supplies.  At one point, Amelia and the girls all went for a special lunch with the Princesses and I was with Ethan and his best friend, Jonah Mace, and their family.  Ethan said he felt low and checked his BG and he was 53.  I told him to go ahead and drink a juice and we would get some lunch.  At that point, we had this exchange:
Me: Okay, get a juice and some crackers in you, brother.
Ethan: Um, dad, you told me to clean out my backpack so mom could use it for supplies.
Me: Yes.
Ethan: So I did, but all of my supplies were in the backpack that mom has.
Me: You didn't restock the kit you have with you?
Ethan: No, I just have my glucometer...
Me: *sigh*

We powerwalked through the crowds, trying to get to a place to buy him a juice and some carbs.  Everywhere I looked, there were long lines for the food vendors (it was lunchtime, remember) and I was worried that he was dropping and would pass out.  Luckily, I was able to get into a store and buy a pretzel and some Apple juice (and two juice boxes for spares) and bring up his BG pretty fast.  I couldn't help thinking that if circumstances were just a little different, I might have had to call emergency services.

MH had one instance where she felt so shaky that she sat down in a store at Disney to check her BG and one of the staff told her she couldn't sit in the middle of the aisle.  MH was so low it was all she could do to scoot over to one side and continue to treat herself with fast sugars, but it upset her.  Amelia spoke to the supervisor and educated them about how to approach someone who was in the midst of checking BG.  She said, "The supervisor had a reasonable expectation that people should not just sit in the middle of the aisle, but when someone obviously has medical equipment out and is checking their blood sugar, a more appropriate response is to ask if she is okay, not to chastise her for sitting down.  I pointed out that it would have been worse if she had passed out while standing up and hit her head on one of the kiosks and bled all over their floor.  The supervisor got my point and apologized."

The return trip home was fine, with no diabetes issues.  But to recap: our vacation was fantastic, but the diabetes part was a drag.  Rollercoaster BG due to diet and exercise changes on the trip, pump failures and supply costs, vet expenses for our poor stressed puppy and trying to manage responsibilities with the kids restocking their kits...

I walk a line of being thankful that our diabetes is manageable (usually) and being resentful of having to manage it at great expense of our time, energy, health and finances.

Diabetes, I hope you enjoyed your time on our vacation.  I wish we could take a vacation from you.