Adventures in Diabetes Parenting: travel

Showing posts with label travel. Show all posts

What Happened in Vegas

Last week's spring break adventure was a colossal road trip beginning and ending in Las Vegas. As usual, we dragged diabetes along for the ride. Between the restaurant food and the time change, there was an incredibly wide range of blood sugar numbers but thankfully no major disasters. Until the last night of our trip.

My daughter's blood sugar was an amazing one-something-something after thoroughly enjoying the Golden Nugget buffet. We checked out the light show on Freemont Street and then walked back to our room leaving the remaining adults our party to enjoy the casino before bed.

No alarms were set. We relied on the Dexcom to alert us of any problems. At 4 a.m., it buzzed. The first buzz is supposed to mean she's crested over 200, and that's what the graph showed.

I located the meter and the flashlight. '505' read on the meter screen. It was so far from what the Dexcom said, I thought there must be buffet residue on her fingers. I wiped a different finger as clean as I could. '485.' So, in my less than awake state, I plugged that number into the meter remote and gave a bolus. Then I thought about it. Something must be wrong.

Indeed, a glance at the site confirmed it was done for: a bloody mess. So, at 4 a.m. in a casino hotel room, I dug out a new set and woke her up. She further confirmed she was very high by immediately chugging half a water bottle. We inserted a new site by flashlight so we wouldn't fully awaken my husband. Why didn't we just do it in the bright light of the bathroom, you might ask? We were half asleep, clearly, since the idea didn't occur to me until just now.

I then guessed at another correction dose, balanced by what might or might not have gone into the bad site a few minutes before. She was in good shape by the morning, and in the end I'm grateful that it didn't happen earlier in the trip. I wouldn't have wanted to be overtired here:

CSI Summer Cottage

Setting: A vacation cottage in a quaint New England seashore village. Specifically a child's bedroom in which all surfaces are draped in white and cream colored fabric including but not limited to the bedspread, rug, doilies, armchair cover and child's shorts.

Scene 1: Mother prepares items for site change. She draws up fresh insulin, gathers supplies from a large plastic bin. Daughter assumes a position for comfortable site insertion and happily finishes a chapter of this summer's Harry Potter book.

Scene 2: Unisolve adhesive remover is applied to the old site for easy removal and IV prep to a new site area for infection-free insertion. Mother and daughter chat about the day's seashore adventures while the wipes do their trick.

Scene 3: Mother peels off the old site. Blood shoots out of it, reminiscent of a fountain. Mother screams, prompting daughter to scream. Mother lunges for tissue box across the room, hands covered in blood. She grabs a wad of tissues and presses it on to the gushing area. Daughter performs yoga moves to elevate the affected area above her heart. The bleeding slowly subsides.

Scene 4: Damage is assessed. Spots of blood are located on the white-covered chair across the room, behind the child. A pool of blood is located in the bed frame in front of the child. Spots of blood are also found in several areas of the rug, bed skirt, child's shorts and sheets. Mother wonders aloud what cottage owners would assume had happened here if the blood could not be cleaned up.

Scene 5: Mother secures paper towels and cold water. Scrubbing commences. Daughter remains in a yoga pose with fresh tissues firmly pressed to the offending area. The white arm chair cover seems most important to clean. Blood is removed with surprising ease, giving mother hope. Rug blood is scrubbed to the point of being difficult to detect. The bed frame wipes clean easily despite a surprising large puddle of blood. The bed skirt is the only remaining item not belonging to the child. This proves more difficult to clean. Mother gives up and returns her attention to the child who still needs a new site inserted.

Scene 6: A new site is inserted without incident. The old one has stopped bleeding but is covered in a band aid just in case. More cold water, then a bleach pen are applied to the bed skirt, with adequate results. Mother then repositions it so a remaining faint stain is less obvious. The sheets have blood stains already from nightime fingersticks, so mother decides they are not worth washing 2 days before vacation's end. Spattered clothing is pre-treated and put in the laundry.

Scene 7: Mother and daughter have showered and dressed in clean clothes. The family sips cocktails (and iced tea) at a semi-fancy seafood restaurant. Mother continues to wonder what a blood spatter expert would make of the scene she has just cleaned up, and how much DNA evidence she has left behind.

Waterproof

My daughter took this picture from her kayak last weekend:

The outing was made possible by Ziploc bags.

It's unlikely that our kayaks will get swamped or tipped on this calm pond. More of a threat are the drips from the paddles, and the wet feet going in and out of the boat.

One gallon sized bag holds the meter, glucose tabs, a juice box and a small snack. It will also hold a small camera.

Circling the pond can take a couple of hours, depending on how many frogs, turtles or loons we need to stop and watch, or how long we stop in the shallows to chase polliwogs.

Knowing the diabetes essentials are dry and at the ready allows us to, for the most part, forget about them and enjoy the water.

Bits and Pieces 3

It's another in an occasional series of posts collating and commenting upon some interesting (at least to me) diabetes links:

Animas has submitted for FDA approval for their Animas Vibe for use in the U.S. The news is summarized here on Diabetes Mine. This product sends data from the Dexcom G4 continuous glucose monitoring sensor directly to the insulin pump, eliminating the need to carry an additonal receiver. Also notable in the article is that Dexcom has submitted for FDA approval for pediatric use of their G4 product, hopefully greatly reducing the red tape families must currently weed through in order to obtain it for their children under 18.

While our family loves to travel and see new things, the airport experience has often left much to be desired. If you haven't done so, please take a moment to sign this petition to standardize TSA screenings for diabetic persons using wearable self-monitoring medical equipment. A look back at a couple of our family's airport experiences can be found here.

It was fascinating to follow Anna Floreen's experiences wearing a Bionic Pancreas. There are seven pieces up on Glu, the first of which is linked here. I'm a realist. I know that the research process moves slowly and that the FDA approval process for even the simplest of things is grueling. Yet reading about someone out in the world wearing equipment which eliminated her need to actively manage her diabetes gave me great hope. One of many take-aways for me was that while this technology will not constitute a cure for diabetes, it will be life changing. Yes, there will still be physical baggage of sites and technology to carry around. Yet the mental baggage will be so much reduced it made me wonder what fascinating things I would think about should technology take over so much of the diabetes drudgery.

Some of these developments seem, perhaps, more significant than others. Yet the bionic pancreas won't be completely anxiety-free if we can't get it through airport security without a fight or a panic attack.

Travel Trouble

A couple of weeks ago, we took our final trip of the summer. It began with a familiar journey of four and a half hours to grandma and grandpa's house. We would spend a night there and then travel another hour and a half with them to a cabin on a pond in the woods. We make this trip once or twice each summer, and I mistakenly believed I could easily pack what we needed without the extra concentration required for, say, our trip to Florida earlier in the year.

The bad omen came three quarters of the way there, when there was a thunk and a subsequent dragging sound. Sadly it was not from a nearby vehicle, but from our own. The muffler had come loose and was dragging down the highway. My husband heroically secured the muffler to the car with a bungee cord and we traveled slowly but steadily to our destination.

We enjoyed a pleasant supper and researched the hours of nearby muffler places for what we hoped would be a quick fix before continuing on our way in the morning. The only other piece of business for the evening was a site change. Which would require insulin. Which I realized, with a sinking feeling, was at home, four and a half hours away.

Hoping against hope, I peered into my in-laws' fridge. Because we visit often, we leave vials of lantus and novalog there for just such a circumstance. Sadly, my memory was correct that the last time we visited, we discovered the insulin to be near its expiration date and brought it home to use and to replace upon our next visit.

It was 7:45 p.m. If we wanted to enjoy the rest of our vacation, we needed a source of insulin by the time the muffler was fixed in the morning. Our other options were heading home, or visiting the local hospital by evening.

As much as I'm a supporter of small local businesses, this night is why we use a national pharmacy chain. The pharmacist found my daughter's name quickly in the computer system and submitted the request for a refill. Their pharmacy would be open until 10.

Then, "Did you just refill this prescription last week?"

"Yes, but I'm visiting family here and am 250 miles from home. I left the insulin at home."

"I'm sorry, but it's not going through on your insurance."

"Ok...well...how much would it be out of pocket?"

"Let me see...Oh WOW...it's a lot. It's $169."

"Hmm...that is a lot."

Funny how fast your mind can work in these moments. I was considering the obviously higher value of my daughter's life, but also the comparative cost of traveling back home to get the insulin and the immeasurable cost of losing out on a vacation when the pharmacist offered, "Let me call your insurance for you. I see they're still open. Sometimes they will override the cost in an emergency. I'll call you back within the hour to let you know."

Twenty long minutes later, the phone rang. Our insurance would pay for it, and it would be waiting for me to pick up in a few minutes.

Site change waited until morning, but was easily done while my husband went to the muffler shop. We very carefully packed the rest of the insulin vial into our significantly quieter car and hit the road. The subsequent discovery of the forgotten water toys, and the need to re-wear the same shorts a few times were issues which seemed trivial compared to the trip's beginning.

Too many people pay $169 every time they need a vial of insulin. Lots of people end up at the hospital because they cannot afford that $169. Countless people have advocated for insurance companies to cover the cost of insulin, even for people dense enough to leave it at home on vacation.

While it was a stressful start to a vacation, the experience made me grateful for what our family has, and for those who make sure we have it. It was a reminder that there's more to do out there to ensure everyone has access to basic diabetes care.

Being Prepared

Here is a photo from Friday: packing the 'diabetes box' for our weekend at Grandma and Grandpa's.

Five sets of site change supplies, four vials of test strips, two spare pump batteries and two dozen syringes turned out to be enough for a three day weekend.