Tag: Diabetes

A Diabetes Vacation Travel Kit

I recently received a few emails from Shoshana Nacass, a writer for Help Around. If you are not familiar with Help Around, it's founders, Yishay Knobel and Shlomi Aflalo, developed an app to make it easy for people to rely on others so as "not to get stuck". I used the app for a few months before deciding that ultimately I would have very little need for it1.

But two of Shoshana's questions had me thinking a bit about how I plan for my diabetes management when travelling and inspired this blog post.

Hi Khürt,
 
How are you?
 
I was wondering how you keep track of the pharmacies nearby, your prescriptions, your doctor appointments, when you have to order more supplies, etc.
 
How do you remember it all?
 
To be transparent with you, we're trying to find ways to make it easier to keep track of it all. Understanding how you're currently dealing with it would be very insightful. Feel free to send me pics of your to-do-list as well.
 
Thank you so much! ~ Shoshana Nacass

All my supplies are delivered mail order. I have only three prescriptions so keeping track isn’t an issue. Anyone with prescriptions so plentiful they can’t keep track of them has more health issues than I can relate to but I think a disciplined and planned approach reduces the likelihood of an emergency.

I use the calendar on my iPhone, iPad and Mac to keep track of appointments. I enter them immediately after they are booked. I set reminders to re-order supplies or I put the supplies on automatic renewal. When I visit with my endocrinologist or physician, I am always asked if I need prescription renewals. My teenage kids know how to use a calendar so I expect this isn’t a challenge for an adult.

And her followup question after my somewhat flippant answer.

Screen Shot 2015-08-12 at 10.04.54 AM

Would you like to be able to see, wherever you are, the pharmacies nearby taking your insurance for example? Could that be a helpful feature on the app? Let me know! ~ Shoshana Nacass

It might be useful to see which pharmacies are nearby if I am travelling and somehow forgot or lost my diabetes supplies. Losing them on the plane, train etc. isn’t likely if I plan correctly. If I keep the supplies needed for the trip on hand (e.g. in carry-on luggage or backpack) then I won't be at risk that the airline misplaced my luggage with my backup supplies. Basically, it is best to spend the time preparing a travel kit.

Assuming a two-week trip, I would pack the following:

  • 5 infusion sets
  • infusion set insertion tool
  • 100 test strips (two vials). I test 6 times a day.
  • 100 lancets
  • A box of alcohol swabs (100 counts)
  • One vial of insulin or two insulin pens
  • Needles for the insulin pen
  • Two CGMS sensors (Dexcom)
  • Prescription for all the above

I’m packing for a one week vacation next month so I’ve already made my list. In fact, this was the first list I made for my trip. If you use Wunderlist you can download the list. These supplies occupy very little space. They can easily fit inside one of those soft lunch boxes along with an ice pack for the insulin. This makes it easier to inspect when going through the security checkpoint at the airport and easy to pack inside carry-on luggage.

If I somehow lost or forgot my supplies, the only items that could be provided by a pharmacy would be the insulin, needles, lancets, and test strips. The last two are easy to find and buy at any USA pharmacy. However, based on my personal experience with a major USA national chain, insulin is not readily available and I would need a doctor's prescription for the insulin and needles.

I have personal experience with driving on a road trip only to realize I forgot to grab my insulin pen and need to have a doctor's prescription to give to an out-of-state pharmacy. After that singular experience, I now keep a smaller version of the travel kit in my car.

  • Two day supply of lancets
  • One vial of test strips
  • One day supply of alcohol swabs
  • One CGMS sensor
  • One infusion set

Due to a lack of temperature control when parked, I don’t keep insulin in my car.

I have developed a habit of going through my checklist before the trip. This has helped me avoid many diabetes supplies emergencies. Plan, plan, and then plan.

My last A1C was a 7.2

Why a Teen with Type 1 Diabetes Lied to her Parents by Lauren Stanford (ASweetLife)

During the time I was burnt out, I was simply that: burnt out. I was not trying to physically hurt myself. I just couldn't mentally bear diabetes management anymore. I never wanted to die and I never wished my life away. It is important to point that out because if I did feel any of those things, this would be a different story. I knew I was going to be okay one day. I really did. I just was not ready to be okay then.

I think I have diabetes burnout. I can relate to what Lauren wrote in her blog post. At my last visit the endo notes that my A1C was a 7.2. This is the first time in the nine yeas since I was diagnosed that my A1C has been over 6.5. In the last 30 days about 51% of blood glucose readings have been in the high range.

Like Lauren wrote, I just can't mentally bear diabetes management at this point. Sometimes I want to smash the CGMS against the wall. Sometime I want to remove the infusion set and not replace it.

Is it Time for a Diabetes Offline Community?

Changing Behavior. by By Kerri

Talking about diabetes in the context of behaviors makes sense to me, because it puts an appropriate balance in play between the influence of diabetes on our actions and the influence of our actions on our diabetes.

Kelly Close of diatribe.org asked an intriguing question on Twitter last week. Kerri Sparling responded with a blog post and Doug Tallman responded to Kerri's post.

Here's Kelly's tweet:

Doug's blog post reminded me of something I've thought about for a while. He is suggesting that the diabetes community needs some sort of mentorship or support group. Here's that part of Doug's post that got my attention.

Things like this occur already online, and lots of good can come from a blog, a Twitter chat, and a Facebook page. But if we want to effect real change, I think it’s going to have to happen face to face. Maybe a dozen people. Sitting in a circle of folding chairs. Possibly in a church basement or an empty meeting room in a government building. The room should be redolent of fresh-brewed coffee. And maybe a dozen donuts for the members who bolused.

While I occasionally take part in the DSMA Twitter event and get "in it" on Tudiabetes.org, I still feel a bit isolated. The JDRF is very active in the area but as one blogger recently noticed, the JDRF feels like a kids-only organization. I only know two other adults with T1 in New Jersey. One of them started a group similar to what Doug was suggesting. But it quickly turned got taken over by T2 seeking advice on diet and exercise. They weren't as interested in talking about insulin, and pumps and CGMS etc.

Right now, I am struggling with weight and exercise. Frankly, I don't exercise and I am 10kg overweight. My BMI is borderline at 25. I am taking statins to manage my cholesterol. When I worked at Sarnoff, I was part of a walk team. A few of us would take 30 minutes from our schedule for a walk around the Nassau Park Pavillions complex. It's a brisk 2.4km walk. We would talk about family and life etc. It worked well for me. But that was two years ago. I consult now and the new work environment is not conducive to walking during the day.

So ... here I am thinking. This is my problem. I could solve this one myself. I could start a group. I could let people on twitter and tudibaetes.org know what I was doing. Then I could go sit in one of the meeting rooms in the Princeton Public Library or the Panera and just wait. Maybe someone will show up.