Four Factors that Impacted my Diabetes in Las Vegas

Recently, I returned from a trip to Las Vegas with my best friends in the universe. It was awesome to take a vacation with them, especially in a place that’s virtually a playground for adults.

Before I went on the trip, I knew to expect some sort of disruption with my diabetes care and management routine. I did as much as I could to prepare myself for every potential scenario, from packing extra snacks and supplies, to asking the DOC how I should account for a sudden change in time.

While my preparation really did help, I still encountered the unexpected when it came to my diabetes on the trip. Four factors in particular come to mind…

  1. The heat – At first glance, this is a no-brainer. I’ve been to many hot climates on vacation, so it isn’t news to me that intense sun can make blood sugar go low quickly. We were literally in the middle of the desert, so I knew it would be important for me to watch my numbers closely, as well as keep myself hydrated. But I think the fear of going low all the time was a little too strong, which meant that I was running a bit higher than I’d normally like for most of the vacation. My paranoia about drinking plenty of water, though, was not a joke. I pride myself on being good about staying hydrated, but I struggled to keep up with the dry desert heat. I can’t help but wonder: If I’d been better about drinking water, would it have benefited me during some of the stickier high blood sugars? Speculation can only get me so far now; however, all signs are pointing to probably yes.
  2. The strip – The Las Vegas strip is less than five miles in length, but the whole stretch of it, marked by hotels, stores, casinos, and ginormous flashing lights, feels incredibly long. Nevertheless, my friends and I naively believed that we could skip taking taxis and walk all over the place. For the most part, we could, but it was definitely dicey when we walked nearly a mile and a half from the Cosmopolitan to the Rio one evening. It influenced my blood sugar in a positive way – the exercise brought my levels down to a nice and stable place – but that didn’t mean it wasn’t scary to walk practically on the highway at nighttime.
  3. The alcohol – I’m well aware of the fact that different kinds of alcohol can have different affects on blood sugar. To minimize blood sugar swings, I stuck with the less-sugary options as much as I could (i.e., opting to order a rum or whiskey with diet coke), only getting fancier drinks when I was consuming fewer carbs at mealtime. For the most part, this strategy worked well and proved to me that a little extra thought can go a long way when it comes to deciding how to treat yourself. But it also reminded me why I don’t have weekends like this often – it’s exhausting enough to take care of myself on a daily basis without alcohol being a factor. Throw it into the mix and I’m watching my blood sugar so carefully that my CGM’s battery is drained in half the time it normally takes to zap it.
  4. The pizza – The scientific answer to the reason why pizza is tough on blood sugar involves the glycemic index and some fairly complex calculations…boring! All you really need to know is that it takes a long time for pizza to have an affect on blood sugar due to its high fat-to-carb ratio. As a result, it tends to be a “treat” food for me that I only indulge in every once in a while. But when in Vegas…you have as much of it as possible. Pizza was one of the quickest and easiest food options for me and my girlfriends throughout our trip, so we ate it multiple times. I don’t regret a single cheesy, delicious bite…but I am slightly remorseful for not doing a better job bolusing for it. The first time we had pizza, I didn’t give myself enough insulin. The second time, I gave myself too much and went low, though that may have happened because I didn’t finish both slices like I thought it would. The bottom line? I didn’t realize that pizza would be a dietary staple on this vacation, and I’ll probably refrain from eating so much of it on future vacations.
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A slice a day does not quite keep blood sugar at bay. But it’s tasty as hell.

Despite the diabetes curveballs I encountered, I enjoyed my trip to the fabulous Las Vegas. I managed the challenges as best as I could without letting them interfere too much with what I wanted to do. Plus, it helped that my best friends were with me the entire time. I have to give them credit for making the most of my diabetes difficulties, too. For instance, I felt badly about sidelining them in the Bellagio on our last night there due to a low blood sugar that crept up on me after walking (the strip!) and over-bolusing (the pizza!), but they really rolled with the punches and made the most of it. In fact, I’m pretty sure they experienced their favorite people-watching moments while we sat and waited for my sugar to come up (I got a kick out of the weird people coming in and out of the lobby, too, but was slightly more focused on raising my number).

Thank you, Kortney and Roshani, for accompanying me on an incredible girls’ trip and for being my best friends in the world. Maybe Las Vegas 2020 needs to happen – now that we know to expect, perhaps my diabetes will be a more cooperative travel companion the next time around!

How Time Traveling Affected my Blood Sugar

I traveled through time last week.

No, I didn’t use a magical device or step through a portal. It’s much more boring than that: I flew across the country, east coast to west coast, to spend a few days in Las Vegas.

Okay, there’s no way in hell that I could justifiably describe my Vegas trip as BORING.

But my point here is that flying through a couple different time zones is totally trippy. And, of course, it impacted my blood sugar. Because why wouldn’t diabetes just cooperatively come along for the ride?

I knew I should anticipate some sort of blood sugar swings going to and from my destination, I just wasn’t sure of when and how they’d hit. But I did know that when I landed in Vegas, the first thing I needed to do was adjust the time on my PDM (my insulin pump). Surely, my blood sugar would not react kindly to thinking that it was three hours later than it truly was in my new time zone. My question, though, was when should I do this? On the plane? After we landed? Should I adjust it slowly, in one-hour increments? Or should I dial it back entirely in one go?

Normally, I would’ve asked my endocrinologist what to do – but I forgot to bring it up during my last appointment with her a few weeks ago. So naturally, I asked the next best source: the Diabetes Online Community (DOC).

The answers I received were varied…

…nevertheless, I appreciated the immediate replies. I decided to quit stressing about it so much and focus on getting to the actual destination, vowing to keep an eye on my blood sugar for any suspicious trends while on the flight.

Five and a half long hours later, my travel companions and I arrived at our hotel. While in line for check in, I fixed the time on my pump and glanced at my CGM (which I didn’t bother adjusting, since none of the settings on it or my meter were dependent on time). I was steady at 97 mg/dL…not too shabby at all. And I’m pleased to say that I maintained that decent graph for the next day or so. I was nonplussed by the phenomenon, but I couldn’t complain about it.

The next few days are a different story, due to some “lifestyle choices” I made while in Vegas (c’mon, you know all I mean by that is eating junk food and imbibing alcohol). But that’s a tale for another post, coming soon.

This one’s about time travel, and while I had no issues flying TO Vegas, I did encounter trouble flying home FROM Vegas. My friends and I chose to a red-eye flight, which I don’t regret per se, but I’d never done one before and didn’t realize how much trouble I’d have falling asleep on the plane. It was disorienting enough leaving one place at 9 P.M. to arrive in another at 5 A.M., but add a freezing cold aircraft, turbulence, and an unsettled stomach to the mix, and you’ve got a recipe for disaster. As I tossed and turned in my seat, violently shivering a few times, my blood sugar was very slowly, incrementally, rising. I didn’t realize how much until we landed and drove home, where I had to bolus for an out-of-the-blue 308 mg/dL. I was so bloody tired, yet sleep evaded me further as I anxiously waited for my blood sugar to budge – which it did, but not for several, agonizingly long hours.

It definitely didn’t help matters that I wasn’t eating regularly; at the time of our arrival home, I hadn’t eaten real food in about 36 hours due to nausea that wouldn’t seem to leave me alone. I’d muscled down toast and a couple of granola bars, but not much else. I’d like to think that my entire body was just rebelling against me for spending the weekend eating too much pizza, staying up too late, and drinking a little too much whiskey, because that train of thought at least helps me make sense of my lack of appetite and recurring high blood sugars.

I’ve been back on the east coast for a couple days now, and I’m relieved to report that things have settled down. I’m eating regular meals (and I actually feel hungry for them), and besides a few flukes in my CGM graph, my blood sugars are mostly back to normal. I wish I could say that there was some big takeaway from this all: that I know exactly what to do next time I travel through time zones, or that I know just what to do to prevent it. But that’d be silly, because with diabetes, there are just too many variables. At least I CAN say that I know to take it in stride next time, to roll with the punches. Monitor my blood sugar like a hawk, correct as often as needed, eat normal meals as much as possible, and drink plenty of WATER. In any case, isn’t that what diabetes is all about…

…regardless of time travel and/or sorcery?

 

Traveling with T1D: Upon Arrival

Bags packed? Check. Made it to the airport? Check. Boarded the plane? Check. Touchdown? Check. I’ve made it through the actual travel part of my trip. Yay! But after all that, I’ve still got a routine to follow, even though I’ve reached my destination.

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This little cooler comes in handy when en route to a destination, but I always feel much better when I can get my insulin vials into an actual refrigerator.

It’s pretty straightforward, really. I simply need to determine where to keep my diabetes supplies for the duration of my stay. If I’m in a hotel room, I locate the mini fridge and stash my insulin vials  in there. I tend to keep everything else (pods, swabs, etc.) out of plain sight in order to avoid attracting attention from housekeeping. I mean, if I was going in and out of hotel rooms all day long and noticed that one contained a bag filled with needles, I’d probably get a little suspicious. So this means my other supplies live in my suitcase for the week, in an easily accessible pocket.

It’s easier if I’m going to be visiting with friends or family. I still find a fridge to home my insulin, but I worry less about “hiding” my supplies. I’m able to keep them in a spot that’s convenient for me, which helps make site changes throughout my trip a smoother process.

Speaking of site changes, I find them particularly annoying when I’m on vacation. It feels like I have to plan a day – or several days in a row – around the fact that I’ve got an upcoming site change. But planning is a part of T1D management, so I’ve come to accept that I need to be diligent with scheduling activities and meals around it.

Sometimes site changes are no big deal on a trip, other times they’re a whole event (like when my mom and I went to Disney and had to change our pods in the parks – going into a family bathroom to do it was not overly fun). And other, more seldom times, site changes are reminders of why it’s so important to pack extra supplies on a trip.

Case in point: My family and I went on a Caribbean cruise a few years ago. It was an amazing vacation, but also one that presented a few challenges regarding diabetes. I was spending a lot of time in the sun and on beaches, and that took a toll on my pods a couple of times. I had to rip off pods prematurely twice on this trip and replace them with my backups. Thank goodness I had thought to bring a pod for every single day of the vacation (seven days, seven pods) – because I wound up using five of them. So I never feel badly about obsessively packing tons of extra supplies that I might not necessarily use, because I never know when they’ll come in handy.

Travelbetes. It can be kinda complicated; hence, it requires its own word. But it’s worth it in the end, because my choice to travel independently with diabetes shows that it won’t stop me from seeing new places.

Traveling with T1D: During the Trip

A few days ago, I wrote about what it’s like to prepare for travel with diabetes. It may have surprised you to learn how many steps are involved! But the work doesn’t end when en route to the destination…

It doesn’t matter if I’m going to be stuck in a car for several hours, flying on a plane, or – my worst nightmare – waiting in the airport for a delayed flight: There are additional steps I like to take when traveling to help ensure my blood sugar is steady and I’m adequately prepared with my supplies.

These steps include:

  • Checking my blood sugar often. I don’t like to rely completely on my CGM; after all, it can be inaccurate from time to time. So I tend to perform more blood sugar checks than usual while I’m waiting at the airport or sitting shotgun in a car. But if I’m the one driving, I (obviously) wait to check at rest stops as time allows.
  • Seeking healthy snacks. It’s definitely easier for me to find healthy options when I’m on a road trip – I can simply pack meals and snacks ahead of time. The airport is a little trickier for me, though. Sometimes, I’m tempted by candy or chips – comfort foods – because I’m not a huge fan of flying and like to do anything to take my mind off it. Luckily, though, even if I don’t make the healthiest choice, everything I’m consuming does have a carbohydrate count that’s easily accessible. This helps me take the correct insulin dosage and removes some extra thought from the process.
  • Getting as much movement in as possible. If this means taking laps in an airport terminal, so be it. I know that my diabetes responds well to exercise throughout the day, but it’s next to impossible to get movement in when cooped up in a car or plane. So what if I look kind of weird at a rest stop doing jumping jacks next to my car? At least I know I’m doing my body some good.

One thing I’d like to note is that the airport comes with some added fun: the TSA!!! (Insert sarcasm here.) That means I also have to be prepared for going through security. Some PWD have reported terrible experiences with the TSA, which is why I’ve devised a protocol for myself when traveling so I can (hopefully) avoid a bad interaction.

This plan consists of:

  1. Having my ziplock bag of diabetes supplies at the ready in my carry-on in case I’m asked to remove it,
  2. Telling the TSA agent conducting the body scan that I have T1D, and pointing out the locations I’m wearing my pod and CGM sensor,
  3. Knowing that I’ll probably be asked to touch my sites (over my clothing), and
  4. Allotting for the extra time it takes to get my hands swabbed.

So far, so good with this little strategy of mine. I’ve found that it works best to stay cool, calm, and collected throughout the whole TSA process. It’s a miserable one at best, but I might as well not exacerbate it by getting in a panic about my diabetes supplies.

After all that, what do I possibly have left to do once I actually arrive at my destination? Be on the lookout for my third and final post in this little series of travel procedures – but certainly not my last on traveling with diabetes, in general!

Traveling with T1D

In a few days, I’ll be jetting off to Washington, D.C. for a week! I’m always filled with a nervous excitement in anticipation of all kinds of trips. Whether they’re to a faraway place or close to home, just a few days long or two weeks, there’s a certain level of preparation I need to do that involves more than picking out a few outfits.

Yep, you guessed it – I’ve got to prepare for apocalypse.

Okay, okay, I’m being dramatic. But not really, because I’ve got to think of every possible diabetes scenario that could happen when I’m away. I could experience multiple pod failures, the batteries might go on my PDM, I could lose the charge on my Dexcom or Verio IQ meter, I might run out of insulin – the list of possibilities goes on and on. How the heck do I go about making sure I have everything I could need on a trip, and backups, to boot?

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A peek inside my (barely packed) suitcase. Note: The pods/backup supplies will go into my carryon…whenever I get around to packing it…!

Here’s a walkthrough of the steps I take to prepare myself for a trip of any length:

  • 7 Days Before I Leave – I come up with a good, old-fashioned and handwritten list of supplies that I’ll need. This includes (but is not limited to): spare pods, alcohol swabs, skin-tac wipes, Humalog vials, backup Lantus vial, backup Humalog pen, Glucagon kit, backup syringes/pen needles, extra lancets, chargers for my meter and Dexcom, extra batteries for my PDM, a bottle of Glucose tablets, extra low snacks.
  • 3-4 Days Before I Leave – I begin to take items out that don’t need refrigeration or special attention. I’ll add them to my carry-on – NOT my suitcase, because that’s not a good idea (what if I got separated from it somehow?) – in a clear gallon-sized ziplock bag. That way, if for any reason I need to take these items out of my carry-on, I don’t have to rifle through it in order to quickly locate them.
  • 1 Day Before I Leave – I charge all of my devices completely. I also double check my PDM to ensure that the battery in it is relatively full. I also run through my handy dandy list from a few days ago to see if I’m missing anything.
  • 4-6 Hours Before I Leave – This is when I’m about to leave the house to head to the airport, and I’m trying to finish up with the last-minute packing. I add my insulin to the clear baggie in my carry-on and check to see that I’ve got extra snacks in both the carry-on and my purse.
  • Just Before I Leave – One of the last things I do before heading over to the airport is check my blood sugar. I have a Dexcom, but it’s not always accurate, so I like to take that extra step of obtaining a fresh reading from my meter.

Bear in mind, these are all of the steps I take before I leave for a trip – there are many more in the during and after phases! Stay tuned for my follow-ups on what it’s like for a PWD during the actual travel part, and what it’s like upon arriving to the destination.

A Mother and Daughter with T1D Take on Disney World

About five months ago, I turned to my mother and asked, “Want to go to Disney World with me?”

“Just the two of us?”

“Yup.”

And just like that, a girls’ trip was born! I was so excited about the prospect of going to Disney World with my mom – the first and only other time she’d gone was back in 2000 – that I didn’t really think about some of the logistics; namely, that it would be somewhat daunting to handle a couple parts of the trip due to both of us having type 1 diabetes. I couldn’t help but wonder and worry about really minor issues, like:

  • How would we handle pod changes?
  • How many extra medical supplies would we need between the two of us?
  • What about food – did I schedule all of our dinners at appropriate times? Would we find healthy options in the parks?
  • How would we keep our insulin vials cool?

It’s not like I haven’t been to Disney World in recent years – in fact, this was my fourth time going in the last five years – but it was just different going with my mom. I was the only T1D there in the recent trips, so I only had to worry about taking care of myself. My mom certainly doesn’t need me to take care of her, but I just get anxious when it comes to making sure we’re both adequately prepared when we’re away from home (and from my dad)!

But I was absolutely not going to let diabetes get in our way. And truthfully? It didn’t, for the most part. After all, we’ve encountered just about every kind of diabetes scenario possible. And we’ve dealt with all of them. Just because we were away from home didn’t mean that all of our knowledge on how to take care of ourselves was going to disappear. Plus, traveling with another T1D comes with a major bonus: They know just as much as you do about diabetes. They’ll understand if you need to have a snack while waiting in line for the Haunted Mansion or if you can’t drink a beer in Germany because you’re too high. They just get it.

Of course, a vacation to Disney World is unlike any other getaway. There’s a lot of considerations to make, particularly if you have T1D. My mom and I made so many memories on our trip (most of them unrelated to T1D), but the following parts of our vacation stick out as I reflect on what it’s like specifically for two T1D girls to go to Disney World.

The most exciting part was having the chance to do something like this with my mom in the first place. For various reasons, I never thought we’d get the opportunity to do a girls’ trip – so the fact that we went was really cool for me (and hopefully for her, too).

The scariest part was planning the trip. I took on this responsibility and was happy to do it, but it was a little added pressure to make sure our daily plans would accommodate our wish lists of what we wanted to do, in addition to both of our diabetes.

The most frustrating part was guessing the carb counts for most of our meals. This is something I would love for Disney to work on – offering nutritional information for as many food items as possible. For the most part, we had success making educated guesses, but it would still be awesome if Disney could be a little more accommodating in this respect.

The most difficult part was finding a good place for us to change our pods. Due to how we schedule our pod changes, they were set to expire when we’d be well into our days at the parks. And even more irritating was that between the two of us, we’d need to change our pods on four separate days of our vacation. So it was definitely inconvenient timing, but diabetes doesn’t care about that! However, we worked it out by asking a cast member (a Disney employee) for some help. She told us that a companion bathroom would be our best bet, so each time we had to deal with a pod change, we located the nearest one and did what we needed to do. It was a little stressful to do our pod changes in such a small space, but the privacy was worth it. And even though it was a challenge, we overcame it.

The most relieving part was what didn’t happen – no pod failures the entire trip! That meant we watched our favorite Beauty and the Beast show at Hollywood Studios without interruption and rode countless rides in Magic Kingdom (her favorite was the Little Mermaid ride, mine was Pirates of the Caribbean) with nary a BEEEEEEEEEEP to be heard.

The most tiring part was walking 10 miles every day of our trip. Yes, 10 miles! We actually made a bit of a game out of it, to see if we could beat our mileage as we traveled from one park to the next. But I can’t say that this part didn’t come without its perks – walking so much really helped our blood sugars! It came in handy if we didn’t bolus enough at mealtimes, and when we were running low from all the movement, we were happy to correct with Mickey ice cream bars.

The most magical part was having dinner at Cinderella’s Royal Table during the Mickey’s Very Merry Christmas Party. Seriously, we lucked out – it’s said that Cinderella’s castle is the hardest dining reservation to make at Disney World, and if you hope to snag a booking, you’d better try to do it at least six months in advance. I desperately wanted to make this happen for me and my mom because Cinderella is our favorite princess. So when I did get a reservation for us, I knew it would be one of the best parts of our trip. Rest assured that diabetes was far from our minds as we milked this once-in-a-lifetime experience!

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The castle looked spectacular for the holidays.

From enjoying a glass of champagne over dinner at the castle to reveling at the gorgeous Christmas decorations adorning the Disney property, this trip was worth it in every way. Thank you to my mom for accompanying me, and an even bigger thank you to my dad for being cool with it. And at the end of the day, it was a pretty perfect way for a mother and daughter with diabetes to kick off National Diabetes Awareness Month, don’t you agree?