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How to Travel Smoothly and Safely with Diabetes

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Traveling plus diabetes can equal…a lot of chaos. At least, it does for me when I don’t take the time to properly prepare for a trip.

I’ve got some tricks up my sleeve when it comes to traveling with diabetes…

However, I’m happy to say that my most recent trip to New Orleans was remarkably mayhem-free, thanks to the steps I took in the couple of weeks leading up to the trip (all that covid nonsense aside). In fact, it went so smoothly for me that I decided now would be a great time to document what I did that helped me travel with minimal stress but maximum organization, before I forget everything I did! So here’s what worked for me:

  1. Making a list. Roughly two weeks prior to my trip, I physically wrote out a list of every single item – related and unrelated to my diabetes – that I’d need to pack for my trip. As I packed little by little in that span of time, I checked off items when I added them to my suitcase. It was satisfying to see the number of items dwindle so that by the morning of my trip, I only had a few things left to pack and I wasn’t worried about forgetting anything major.
  2. Having extra snacks on hand. A few days before my trip, I went to the grocery store and bought snacks. Like, a bunch of them. A few boxes of granola bars, some fruit snacks, things that were generally easy to transport and wouldn’t melt in any condition. This ensured that I would have food on hand at all times for any scenario, whether it be a low blood sugar or simply staving off hunger.
  3. Optimizing organization. One of my favorite “tricks” when it comes to packing is utilizing storage cubes! Some people might find them totally unnecessary, but for me, they equate instant organization. When they’re filled completely, they become little rectangles with handles attached to them, so packing my suitcase with the filled cubes is almost like planning a game of Tetris – except it’s even more satisfying because I know I’m doing myself a favor by sorting clothing items away from medical supplies, and keeping things like charging cables separate from my toiletries.
  4. Storing insulin properly. The last thing that I pack for any trip is my insulin. It’s literally the final thing I slip into my backpack before locking up my house. This is to help keep it cold for as long as possible, but then to also prolong the cold temperature of my insulin storage pouch. It does a pretty good job of keeping insulin cool, but on a longer travel day where I’m logging a couple hours of ground transportation, a couple hours of airport waiting, and a few more hours of actually air time, it does lose some of its effectiveness as the ice packs slowly melt. So I like doing what I can to keep the ice packs as cold as possible for as long as possible.
  5. Wandering the airport to keep blood sugar at bay. This might be the one element of my last trip that I would’ve liked to change, because I didn’t have as much time as I would’ve liked to pace around the airport before boarding my flights. I have used this strategy effectively in the past, though – my blood sugar and my restless body have both benefited from a few extra steps prior to a flight.
  6. Keeping all supplies within reach. Any diabetes supply, whether it was as sensitive as my insulin or as mundane as a back-up vial of test strips, stayed secure in my “personal item” – the bag that you can bring on a plane that doesn’t have to be stored in the overhead storage bin, it can actually go under the seat in front of you. For me, it’s not worth running the risk of needing any type of supply in the middle of a flight, only to be unable to reach it because it’s tucked away in storage (or worse, a checked bag that you can’t access at all). Knowing that I can get anything I might need, at any time, goes a long way in curbing my anxiety.
  7. Eating consistent meals. In my humble opinion, I actually think the options at airports are pretty decent these days and that makes it relatively easy to find an option that will work at any given mealtime. For example, I got a Starbucks breakfast sandwich the morning of my trip that helped my blood sugars stay steady, and on my trip back home I found a Caesar salad that was lighter on carbs to eat for lunch, which didn’t spike my already-slightly-high blood sugar further. I was tempted to skip those two particular meals because I was running short on time, but I’m glad I ultimately made eating a priority because I do think it made my numbers more stable.
  8. Staying hydrated. Last but certainly not least, I always have a bottle of water on hand when traveling. Always! I make it a mission to down at least one full bottle before going through security (that way I don’t have to waste it by chucking it), and then one of my first tasks post-security is to find either a water bottle refill station (most airports have these now and they’re awesome) or a store selling water bottles. It’s important to stay hydrated everyday, not just travel days, but there’s something about the stress of travel that makes me extra keen to keep drinking water. Plus, high blood sugars are already a nuisance to deal with – without water, they’d be even more insufferable and tricky to deal with when also trying to get from point A to point B!

So those are the things that I did to make this last round of travel go so well. What about you? Do you do anything special to prep for a trip that wasn’t featured on my list? Let me know in the comments!

A Little Bit More Under the Weather

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Remember that post I wrote last month about my bout of covid? If not, you can read it here…and then come back to this post for the update.

The update is that my covid experience wound up lasting longer than I thought it would. You see, after completing my doses of Paxlovid, I was starting to feel great! I think I had about 5-7 days of normalcy before things took a turn and I officially got a case of rebound covid.

That’s right, it came back to haunt me. On a Sunday, days after finishing my Paxlovid, I noticed that my throat began to feel a little funky again. It was just as tingly as it felt at the initial onset of covid, which was a sign to me that perhaps I wasn’t out of the woods just yet.

I spent most of May feeling…a bit under the weather.

Sure enough, the next couple of days my symptoms intensified slightly. Only they were a different set of symptoms compared to my first round – this time, I was dealing with an extremely itchy and agitated nose. It could’ve been so much more worse, and I’m grateful it wasn’t, but my mental health seriously suffered when I took another at-home covid test that Monday and learned I was still positive.

At that point in time, I’d been in isolation for three weeks. This meant I’d have to complete another 10 days, at a minimum.

I was devastated. I was missing my family and friends. I felt like a prisoner in my own home, bound here because it was the right thing to do in order to protect my loved ones, but also resentful of how confined I was because overall, I really didn’t feel that bad. But I wouldn’t change a thing about my quarantine period because it was ultimately the only thing I was in control of throughout the whole experience, and having control over whether or not I exposed people to covid provided me a sense of comfort.

I was also extremely distraught because my business trip to New Orleans was rapidly approaching, and I knew I wouldn’t be able to travel again unless I started testing negative. So the following Tuesday after I tested positive again, I began consulting my healthcare team and we decided that I might benefit from receiving a monoclonal antibody infusion to help my immune system recover faster. Just like that, all my hopes became tied to this infusion as I longed for it to both alleviate my symptoms (even Benadryl wasn’t helping my itchy, sneezy nose) and help me produce a negative test as soon as possible.

Fortunately, the infusion did its job. Within 48 hours, I was feeling much more like myself. Even better, four days after receiving it, I began testing negative. I was beyond elated and relieved.

My covid ordeal taught me a few things. Number one, I feel so very lucky that I had access to the means to get better: a capable healthcare team, medical treatment, an understanding employer who let me take as much sick time as I needed, and the like. Number two, I feel similarly lucky that my diabetes seemed totally unaffected by the illness. I can’t imagine how much more difficult (and frustrated) it would’ve been if I’d also been chasing lows or highs. Number three, I’ve got so much more appreciation for the people and things I took for granted prior to my quarantine. I was absolutely giddy the first time I left the house after testing negative, and honestly, that feeling hasn’t changed with every subsequent plan I’ve made in the weeks that have followed.

Most of all, I’ve got a new level of gratitude for my support system: my family, my friends, my partner, and everyone who checked in on me when I was feeling depressed and lonely in quarantine. I would’ve been lost without them.

ADA 2022: An Incredible Experience

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June began with one of the most wonderful experiences of my professional and personal life with diabetes…and that is the American Diabetes Association’s 82nd Annual Scientific Sessions conference.

I attended as part of my job at the College Diabetes Network and already felt very lucky that I was offered the ability to go. But I felt doubly fortunate as it was unclear whether or not I’d actually be able to go about a week prior to the event. As I briefly mentioned in Monday’s blog post, I had a rebound case of covid at the tail end of May and spent the days leading up to the conference feeling fairly frantic about coming to terms with the reality that I may not be well enough to attend.

Fortunately, everything worked out in my favor – and I’m so beyond glad that it did.

Beaming with excitement at the conference convention center!

Attending this conference reignited my passion for what I do and the community that I aim to serve. For the first time, I was able to connect in-person with so many powerhouses working within the diabetes sector, hear about the amazing work they’re doing, and learn about the many exciting advancements being made in diabetes care and research. The energy and vivacity was practically tangible, and it reinforced the importance of the work that I do.

I didn’t attend this conference alone, though: Besides a few of my CDN colleagues, I was also accompanied by some of our NextGen Fellows. (Read all about the NextGen program here and meet this year’s fellows here and here.) Watching them get to know one another, network with individuals they admire, and share their stories was awesome and evidence of why the program matters.

My gratitude over this experience is endless: I’m grateful that I met everyone that I interacted with, that my diabetes was (relatively) well-behaved and that I didn’t run out supplies, that I learned so much, and that I was able to go, period! I can’t wait for future opportunities like this that allow me to connect in-real-life with the awesome diabetes community.

Listen to This is Type 1 Podcast, Episode 147!

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Whoa, I feel like so much has happened since I last posted on this blog.

Usually, I plan and write blog posts about a week or two before they’re published here on Hugging the Cactus. But life last month made it pretty damn difficult for me to keep that schedule.

You see, I had covid (as I discussed here). And then…I had rebound covid. I’ll get into the details of what that looked like for me sometime in the near future, but I’m happy to say I’ve fully recovered. And thank goodness I did, because I was due to travel to New Orleans for the 82nd Annual American Diabetes Association’s Scientific Sessions conference at the beginning of June! Luckily, I was feeling better and testing negative just days before the conference, so I was still able to go and I had the most incredible time – more to come on that in another soon-to-be-written blog post.

As I write this particular post, I’m in a post-conference daze, trying to reflect on everything I learned, how it will apply to my job, and also attempting to decompress from 6 days of nonstop action, meetings, conversation, and travel.

But I’d be remiss if I neglected to mention something special I did prior to my conference and covid experiences: I was a guest on the wonderful This is Type 1 Podcast!

From episode 28 to 147, Colleen, Jessie, and I have each experienced so much personal and professional growth that we chat about in the new episode!

I’m honored to say I was hosts Colleen and Jessie’s first repeat guest. I’d recorded with them previously in January 2020, just a few short weeks before the whole world shutdown. They’d kept in touch with me and my activities via social media in the last couple of years and reached out for a follow-up interview because they’d recognized how much my career (and life, really) has changed since the onset of the pandemic.

So I’m pleased to share with my readers here the link to the recording! Please do check it out when you can – Colleen and Jessie are excellent and informed hosts who were genuinely so easy and fun to talk to. I am beyond grateful to them for asking me back on the pod and making a meaningful contribution to our diabetes community with all the information they share there!

You can listen to This is Type 1 on Stitcher, Apple Podcasts, Spotify, Google Podcasts, and generally, any other place you can find and listen to podcasts. Be sure to check out their website and follow them on Instagram @thisistype1pod, too!

Travel Time…Again

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This past September, I wrote a blog post (that you can read here) about the emotions surrounding my first plane flight and travel plans since the start of the pandemic. Primarily, I was feeling a lot of anxiety and nerves, but the trip wound up being wonderful and proof to me that I am still a very capable traveler who can adapt to the new travel norms of the last couple of years.

Now, I’m feeling a different level of anxiety and nerves over traveling again – this time, solo, to an entirely new place. I’m traveling for work to a state I’ve never been to before, which is definitely exciting, but also a little scary for me. And that’s kind of funny for me to admit, seeing as I used to travel by myself all the time and it was no big deal.

Traveling + diabetes = travelbetes.

But it’s been years since I last traveled alone, so now I’m rusty on the old tried-and-true routines I followed back then that helped me feel more prepared before and during a trip. It’s also my first trip post-personal experience with covid, which you would think would decrease my stress levels because I’m likely to be protected by antibodies (in addition to my original vaccinations and boosters). On the contrary, it just makes me more uncertain about the steps that I should take to protect myself and others as much as possible – for example, do I make sure to wear a mask at all times, or can I be a little more lax about it?

As I navigate my shaky self-confidence in my ability to travel solo and how to best take care of myself, I’ve come to at least one conclusion that will assuage both concerns: Prepping ahead of time is key. Two weeks prior to my trip, I started packing my suitcases and making a list of everything I need to bring with me, checking items off as I’ve added them to my luggage. I’ve even started packing as many diabetes supplies as I can (saving something like insulin for last, obviously, because it needs to stay refrigerated) and taking care to double or triple up on everything, such as my pods or vials of extra test strips. It’s a little challenging to try to think ahead on everything I might need on this trip, but as any person with diabetes can tell you, it’s so important to plan for any and every possible scenario that could occur when traveling.

And I know my future self will be thanking me for taking the time now to do so much of this preparation. Goodness knows I would not want to do it all the night before!

Despite the varying levels of worry I have about this trip, I know that doing all of this prep work will keep both me and my diabetes happy and healthy, as well as help ensure that I can even have a little fun while on this business trip.

Why I Called Quits on Metformin

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This post was originally published on Hugging the Cactus on December 6, 2019. I’m sharing it again today as a follow-up to Monday’s post, which explained how I was introduced to Metformin. This one covers why I decided to call it quits on my Metformin journey. Read on for the full scoop…

Well, well, well…looks like I’ve got another Metformin update for you all.

You’ve probably lost track of where I am in this long, twisting journey with the pill. (If you need a refresher, all you need to do is click here and read through my original posts.)

All caught up? Great. Now you really understand how complex my relationship with Metformin is.

There were times that I loved it. There were times that I hated it. And there were times when I simply couldn’t be sure if it was working for me the way that I’d hoped and needed it to.

I thought Metformin was right for me, but it turns out it definitely is not.

This last go-round represented the latter thought: Metformin simply wasn’t cutting it for me.

I’d been taking one pill daily for about a month when I decided to quit. The reason why I stopped taking it is simple: I wasn’t noticing a dramatic reduction in how much insulin I take each day. It was maybe a one or two unit drop, and that just doesn’t justify me taking a pill like this on a daily basis.

Now, you might be wondering why I didn’t amp up my dose. After all, it says right on the bottle that I can take up to four pills daily. Well, I chose not to take more for a few reasons: 1) I’m in between endocrinologists right now, and don’t really have anyone to consult regarding dosage, 2) At one point in time, I thought I noticed side effects of taking Metformin, and I’ve convinced myself that any possible side effects would intensify with a higher dose, 3) I wasn’t sure whether the higher blood sugars I was dealing with in the fall were due to stress or permanent changes that my body was experiencing.

So yeah, as you can see, it’s not a cut-and-dry answer when it comes to me increasing my Metformin dose.

I feel like I’m in a better place now with my blood sugars and daily insulin intake. Certainly, things have improved compared to how they were in September and much of October. Rather than fret over taking “too much” insulin every day, I’m going to focus on things that I have greater ability to control, such as the foods I choose to eat (that may or may not impact how much insulin I need) and the levels of exercise I get each week. I feel like that’s a healthier, better way to take care of myself.

So…farewell, Metformin. I won’t miss you. I know you do great things for other people with diabetes, but I’m not sure that you and I are a good match.

Molly, Meet Metformin

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This blog post was originally published on Hugging the Cactus on February 25, 2019. I’m sharing it again today because when I initially started taking Metformin, I felt really alone because I didn’t know any other person with T1D who was also taking it. It is my hope that talking about my experience helps someone who might feel similarly or would like to hear from a fellow T1D what it was like to start Metformin. Read on for more…

You may have read the title to this post and said to yourself, “Met-WHAT?”

Metformin is the new medication I’ve started taking (along with my typical insulin) to help regulate my blood sugars.

Maybe you didn’t make it all the way to that second sentence; instead, maybe you just Googled Metformin to learn more about it. And you probably immediately got confused, because the Google search results explained that Metformin is a medication normally prescribed to people with type 2 diabetes. You know that I have type 1, though, so what gives? Why am I taking this new pill?

You see, for about a year or so, my endocrinologist has been gently encouraging me to try Metformin. She expressed concerns over the fact that I’ve had diabetes for more than 20 years, and in that span of time, I’ve had to take a lot of insulin. Like, an incalculable amount. And while that insulin helps to keep me alive, there’s also risks associated with it. Namely, she explained to me that there’s research that indicates that people with type 1 who rely on large amounts of insulin have a higher risk of developing cancer later in life.

It took a long time for me to feel ready to try Metformin, but I’m glad I didn’t start it until I was comfortable doing so.

Whoa. The “c” word. Something I never thought I’d hear during a doctor’s appointment. If you know me personally at all, then I’m sure it’s not hard to imagine that I pretty much shutdown at the mention of “cancer”. Almost immediately, I panicked and asked why she thought this research was worth mentioning. She said that it was part of her reasoning for wanting me to start Metformin. The idea is that it would make my insulin more effective, and ultimately decrease the amount of insulin I need each day. She went into a little more detail, mentioning that the only side effects tend to be nausea/upset stomach – and that’s when I stopped listening. I politely told her that I didn’t think Metformin was a wise option for me at that time, and later that day, when I took to Twitter to ask other T1Ds what they thought, I gained swift validation that I’d made the right decision: Other T1Ds with Metformin experience told me that the stomach issues they had when taking it were miserable and that they wouldn’t recommend giving it a try. Plus, I consulted with my T1D pharmacist aunt, and her opinions matched those of the other T1Ds on Twitter. So that was all I needed to hear to feel at peace with my choice to not take Metformin.

In fact, it was enough for me to turn my endocrinologist’s offer down during our next two or three appointments. I was relieved that she never pushed me to try it, but there was a small part of me that wondered whether I should give it more serious consideration. Maybe I should let her talk me into a little, rather than brushing it away and using fear as my excuse.

So we did talk about, during my most recent visit with her earlier this month. She gave me some more compelling reasons to consider taking it. Not only could I reduce my insulin intake, but it might also help me with some preexisting digestive issues I’ve had since childhood. When I asked her about the negative side effects on the stomach that I’d read about online, she told me that she would only prescribe me the “extended release” version of Metformin, which had a much lower (if any) chance of inducing nausea or any less…desirable gastrointestinal disorders.

This news definitely perked me up. We discussed a plan for introducing Metformin to my body: Start by taking one pill daily after dinner. Increase by one pill each week until I’m at four pills per day, the limit. At any point in time, I could message her with questions if I started to notice low blood sugars in the evening.

I felt reassured by this logical plan, as well as her explanations of the benefits of Metformin. So I bit the bullet and I’m in my first week of incorporating it into my post-dinner routine. I can’t say that I’ve noticed even the slightest difference, which isn’t a bad thing. I imagine that will change as my dosage increases.

I intend to blog about this new journey with Metformin; not just for the sake of keeping track of how it affects me, but to also help inform other T1Ds who may have been or may be in the same situation that I was. We’ll just have to see how it goes, but for now, rest assured that I’ll be honest in my writings about my Metformin experience. At this moment in time, I can’t help but feel hopeful that down the road, I’ll be glad I made this decision when I felt ready for it, as opposed to when I was fearful of it.

A Bit Under the Weather

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Well, it finally happened…I tested positive for covid.

The past couple of weeks have been an absolute blur as I first dealt with my boyfriend’s bout of covid – during which I felt totally healthy and well – then woke up one morning with a sore throat that immediately signaled to me that I hadn’t managed to avoid it, despite being fully vaccinated and double boosted.

I’m grateful for my constant companion, Nurse Violet, throughout this whole ordeal.

But I think it’s because of those vaccinations that my personal experience with it has truly been very mild. I’ve had no symptoms other than a tingly throat, body aches, and a general sense of fatigue. The body aches have definitely been far from pleasant, but the silver lining in this whole situation is that my blood sugars have been completely and totally normal (knock on wood that this trend continues, seeing as I’m still positive as I write this post). They are maybe running just a tad bit higher than usual because I’m getting very little movement in throughout the day, but really, it’s nothing I can’t handle. And since I’ve started taking Paxlovid (as prescribed by my primary care doctor), I’m hopeful that I’ll be on the upswing of things before long.

In the meantime, though, it’s time for me to try to relish in taking it easy for a few more days as I complete my isolation period.

My Experience Attending the ADCES All-State Meeting as a Panelist

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Talking to one doctor or healthcare provider can be intimidating. It’s not exactly my idea of “fun” to sit in a stuffy room with a medical professional and discuss various health concerns. But what about talking to dozens of them, all at the same time? Forget about fun, it sounds like downright torture.

Fortunately, “torture” is not the word I would use to describe my experience speaking as a panelist at the ADCES Massachusetts All-State meeting earlier this month.

I really enjoyed the opportunity to speak on this panel.

Rather, words like “empowering”, “therapeutic”, and “reflective” sum up how I felt during the event, and I was pleasantly surprised by that outcome. After all, I had no idea what to expect – I was there sort of on behalf of my job, but also as a favor to a former colleague who was leading a session about navigating young adulthood and diabetes; in particular, what it’s been like to transition into the “new normal” of working from home, relying on telehealth visits, and dealing with record-high levels of mental health crises among the young adult population as a result of the pandemic in the last couple of years.

You know, just the type of light and fluffy stuff people love to spend Saturday afternoons discussing, right? (Yes, that was a sarcastic statement.)

Despite the heaviness of the subject, it was a really positive experience for me because I was able to be completely open about my experiences in a room of surprisingly engaged diabetes healthcare professionals. I say “surprisingly” only because I was speaking to a room of complete strangers who knew nothing about me, but that turned out to be the beauty of the entire discussion – I was a neutral third party whose experience they could learn from and take with them into future appointments with T1D patients my age. Similarly, I was able to draw from my own experiences with healthcare professionals in the last couple of years and elaborate on what’s worked (and what hasn’t), which was healing for me to talk about because as I’ve written about here in the past, I’ve had some less than satisfactory encounters with my doctors since the onset of the pandemic. It was also nice to feel like I was really being heard by these individuals, who reacted to my stories with empathy, kindness, and concern.

All in all, I’m pleased that this speaking opportunity went so well, and I’m grateful that I will have additional chances to be at events like this in the future, thanks to my job and diabetes community connections.

What Every Parent of a T1D Child Needs to Know

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This was originally published on Hugging the Cactus on August 28, 2019. I’m sharing it again today because due to various events in my life lately, I have a whole new appreciation for just how challenging it can be to be a parent to someone with diabetes. It’s far from easy and I give all the credit in the world to parents of children with diabetes. But I also think it’s worth reiterating that despite all the (valid) fears and concerns that parents have about their T1D children, it’s also important to have faith in knowing that it will all be okay. Read on for more…

I may not be the parent of a T1D child, but I am the T1D child of my parents. So I have a unique perspective on the concerns and fears that a parent of a T1D child might have.

I also have a little more insight on these concerns and fears through my interactions with many parents of T1D children over the years. These parents had children of all ages: from toddler to teenager. Their children ranged from newly diagnosed with diabetes to multi-year veteran of T1D. Despite these differences in ages and years with diabetes, they’ve all had something major in common: An intense fear over the day when their child would make the transition from living under their roof to living independently, on a college campus or in another living situation.

The bottom line? It will be okay.

The mere thought of their beloved son or daughter going through this was enough to make some of these parents on the verge of tears. It was heartbreaking, but also somewhat confusing to me. I understand the unconditional love that parents have for their children, so naturally, they were terrified at the thought of their children feeling alone as they made the transition to young adulthood, or frightened by the prospect of their children suddenly not wanting to take care of their diabetes anymore. But what I didn’t get was why they automatically assumed the worst.

What if their child thrived in this transition? What if their child found a wonderful group of people, such as the College Diabetes Network, that helped them through this period in life (like I did)? What if their child was ready to manage everything on his or her own? Certainly, it would be a source of pride for a parent to witness his or her child do well and embrace independence.

On the flip side, if a young adult with T1D struggled to make the transition smooth…well, I told many of these parents that it’s okay. Because I struggled. A lot, actually. But I made it through. The longer I spent away from home, the more I realized that it was time for me to hold myself accountable in terms of diabetes management. There was never really any big “aha” moment for me. It was more of a slow-and-steady recognition of the fact that the shitty blood sugars I was constantly dealing with could only be changed by me, and me alone. So I took the steps I needed to; naturally, with the support of my parents.

I guess that’s kind of the two-fold message I’m trying to convey here to worried parents of T1D children: 1) Have faith in your child’s ability to adapt to change, and 2) Never underestimate how your support, in any form, can mean the world to your child. Don’t be afraid to have conversations with him/her so you can get on the same page and understand how you’re both feeling about this new life stage. That way, you can find out exactly what kind of support you can offer to your child that he/she will find most helpful.

The bottom line: Parents with T1D children, it’ll be okay. Just like people with diabetes know they’re not alone in their struggle against it, you should also know that there are many other parents out there who probably feel the same as you.

In that way, we’re never truly alone when dealing with new challenges or changes in our lives. Once that’s realized, it becomes a million times easier to figure out the best way to tackle them with your support system by your side.