Travelling with our diabetic child

Well November is coming to a close, so in honour of World Diabetes Month, I thought I would make a diabetes awareness post. I know that after Sophie was diagnosed, I spent a lot of time on the internet, searching everything – including how to travel with her. I found it best to read personal accounts from people who have done it – not just generic lists or tips of websites like Diabetes Canada or JDRF. I mean, those were helpful, but not exactly what I needed. I needed to hear from someone who had made mistakes and figured out best practices by actually doing it.

So I’m here to share our tips and tricks, so far. I hope we’ll have a lot more in the years to come! But it’s November, so here’s what I’ve got:

Pack extra, and then a little extra more

You may think it’s ridiculous, especially when you’re only going away for one night, or a week-end, and you see the enormous amount of supplies in front of you, but just pack them all.
Our rule of thumb is pack 3 times what you plan on needing. If you plan on needing one pump site change and 200 units of insulin for it – you bring 3 pump sites and 600 units of insulin. See? sounds ridiculous.
There’s a few reasons for this.
One: Because you need to split up your supplies into 2 bags. Never carry all of your supplies in one bag – what if it’s lost? or compromised? Then you’ll have at least what you need and a little extra in a second bag.

Two: Life happens– duh. A pump site fails. Or heat ruins some insulin. An insulin vial breaks. A CGM sensor falls off while swimming….

Three: Your child (or you, whoever the T1D is) cannot LIVE without those supplies, why the heck would you scrimp on them? “Oh I want to bring an extra dress so I think less insulin pump supplies this time…” If these are your priorities, give yourself a shake!

And yep- most trips, you’ll find yourself bringing home 85% of the supplies you packed- cool! I just take out the insulin and keep the bags ready to go for the next trip. But every now and then, you’ll be damn glad you have it all there.

True story- when we went to London for just one night, we brought one suitcase between the 3 of us and the regular huge amount of diabetes supplies. We knew Sophie would be due for a pump change that night, so we had 3 pumps with us. I put 2 in the suitcase and 1 in Sophie’s bag that she wears on her at all times. Well, it was incredibly hot that day. So hot that the Beefeaters at the Tower of London had to cut their tours short (because they wear very hot uniforms). The pump kits note on their packaging to remain below 30°C and we knew that the pump in her bag was probably boiling in the sun at around 40°C. I wasn’t sure that pump would be good anymore. (It has a battery inside with Bluetooth receivers so that’s the part that could mess up). So we were down to 2 good pumps. Then that evening when we went to change her pump with one of the good ones in our suitcase, we filled it full of insulin and set it to prime— and it didn’t prime. Faulty pump set. We then grabbed the third and last one we had, filled it, and held our breath. It worked. In fact, we held our breath until we got home almost 24 hours later. (We kept the one that had been in her backpack but got too warm, we’d try it if we had to).
Everything worked out in the end – but only because I packed 3x what we needed.
Because of that night, when my husband sees the immense amount of kit I pack for our trips, he doesn’t bat an eye. He takes a shirt out of his suitcase to make room. Sometimes he even suggests we need more.

Security

Anyone who has travelled in the past 18 or so years knows that airport security can be a real nightmare- for all of us.
So how do we deal with so much security, a growing line-up behind us, and the huge bagfuls of needles, devices, liquids, and contraptions (above) that can’t go through the x-ray machine?
Oy.
(Tip: Early in your planning stages, contact your device(s) manufacturers and find out what can and can’t go through the x-ray machines. For example, Dexcom recommends its sensors not go through x-ray. Omnipod says their pods can, but we prefer to just keep the stuff all together and not risk it – sometimes each bag has ~$1000 worth of medical supplies in it, so lets just have those inspected by hand….)

In England, you can get these sunflower lanyards. They identify an invisible illness. How fantastic!!! These can be acquired by going to the service/help desk in any English airport and telling them why you need it.
We got one for Sophie. We also got one for me but I don’t need it as my illness isn’t invisible in an airport- they see me walking with a cane and are usually quite helpful.
However, only English airports recognise these lanyards right now. We hope that one day, this catches on worldwide.

Anyway, with this lanyard, we can take the handicap line through security (again, we would anyway because of me and my cane, but I’m assuming that most people reading this don’t also have someone in the family with MS… though that correlation is a topic for another day).

When we get to the line, we are prepared and we need to be brisk. We quickly self-identify to the nice folks running the x-rays and security lines that we have some medical devices that cannot go through the scanner and need to be hand-inspected. We always have a doctor’s note to prove this, though they hardly ask for it. (The only time they asked was when we were moving to the UK and had 6 months’ worth of supplies in our hand luggage).

The diabetes bags are always packed on the TOP of our hand luggage so we can grab them quickly and hand them to the security officer. Then Eric and I split up. I realise this is easy to do as we are 2 parents with 1 child. One of us always keeps an eye on the diabetes bags (a: to not lose them, b: to make sure they don’t get sent through the x-ray machine, and c: to answer any questions to the security officers about what is in them) and one of us keeps an eye on our daughter. She’s 11, she can handle walking through the metal detector by herself, but because of the devices she wears, she often sets it off, and they have to pat her down, or swab the devices, which they’re not allowed to do without a parent present.

Then, when we’re in a foreign country and we don’t speak the language, it’s a whole new ballgame. We are trying to make sure to learn the words for insulin, diabetes, medicine, ‘no x-ray’ and ‘medical device’ in the language before we go. I’m sure we still have a lot to learn on that matter.

Bottom line – be prepared. Have the diabetes bags separate, easy to grab, and a doctor’s note from the clinic (I have yet to encounter a clinic that won’t provide this). If you don’t feel at all confident in the language, you can get these notes pre-translated.

Lows

As you know, hypoglycaemic events (low blood sugars) will happen. Every type 1 diabetic is always on the lookout for them and if they are hypo-unaware, then hopefully they have a continuous glucose monitor alerting them of dropping glucose levels.
However you monitor your child’s low glucose, the main thing is to then feed them glucose to get it back up to a healthier level. We all have our tried-and-true ways of doing this while at home, but when travelling it can be very different.
Something to know before you leave home is how to read nutrition labels in the location(s) you are travelling to, because they’re different everywhere. Also, possibly look into the brand names of things like glucose treatments in that country – I know that 4g dextrose tabs go by an entirely different brand name in Canada than they do in England, so it was helpful to know the name to ask for when we moved here.

Photo by Foodie Factor on Pexels.com


Sugar can be found anywhere in the world, so it’s not an immediate worry – you will find something to treat lows. But if your child is picky, or you like to be very specific about how many grams of sugar they get for the low, it’s best to come prepared. Don’t assume you’ll find what you want, or even a close substitute in another country.
But no matter what, always, always, make sure you have some on you. If you’re travelling and walking around all day, there may be some unexpected lows. Having to try and find a store in an unfamiliar area and buy candy/juice/pop in unfamiliar packaging in an unfamiliar language with unfamiliar currency is just not a stress you need at the moment of a low.


Time Zones

This is another aspect of travelling that no one likes, but I never thought of as anything more than an annoyance until we were travelling with a diabetic.
You know how you often have different insulin-to-carb ratios for different times of the day? Or different basal rates throughout the day programmed into your pump? Well, when you just jump 3, 5, or 8 hours and your body has NO idea what time it is; if it just ate breakfast, lunch, or dinner, then you have no idea how much insulin to give it!

Before we moved here and put Sophie’s body through an 8-hour time change, we researched different methods that some diabetics used. Some changed their pump an hour a day. Some stayed on origin’s time for a few days. There were a bunch of options. We went for the rip-off-the-band-aid approach and did it all at once.

When you rip off the band-aid and change the time all at once like we did, be ready for a solid 24-48 hours of wonky blood sugars. But we stuck with it, made her eat on schedule, and they started to make sense again by the second day.

Everyone will have to come up with a plan that’s right for you or your child regarding time changes – it may have to be by trial and error. Start with what you’re most comfortable with and see how it goes.

Eric changing the time in Sophie’s pump by 8 hours as we landed in England.


Those are some of our bigger talking points. Keep in mind, we’re still learning, still experimenting! Below are some more quick tips we’ve picked up along the way:

-Call your airline ahead of time, they can grant you extra hand baggage which can be invaluable when travelling on a budget airline that restricts everyone to one small bag each!

-Watch the temperatures of your bags. Certainly, keep the insulin in a cooler pack like a Frio wallet, but just as I explained above with our London day-trip, certain supplies shouldn’t get too hot or cold too. These are usually labelled on the packaging. And no, you don’t have to be ridiculously strict about this, but you also don’t want to let your black suitcase sit in the hot sun on a 30°C day while you sit on the beach.

-If you’re on a longer flight that provides drinks and meals, don’t request the diabetic meal! They’re gross, and a type 1 doesn’t need it, you just have to guess the carb count.
As for drinks, I have yet to encounter a comfort drink trolley that offers anything other than Diet Coke (or Pepsi) as a sugar-free option. If your child wants to drink something other than water or caffeinated cola that they don’t need insulin for, plan ahead and buy some diet pop in the airport (once you’re through security).

-If your child uses a phone for their Dexcom or any diabetes management, know that you do have to put the phone into airplane mode. Airplane mode will first turn off the transmitting function of Dexcom. However, you don’t have to give in and live on fingerpokes. You can go into the phone’s settings and while in airplane mode, manually turn on Bluetooth. If Bluetooth is on, Dexcom will transmit to the phone and alarm, if needed. However, it will not send the data to any followers.

-Don’t forget to pack back-up needles/pens! We all know the pump can die completely. Or she could drop it in a toilet! We have to be prepared to always give insulin- always.

I know it all sounds like a lot of check-lists, warnings, and planning, and it is – but we also believe that the opportunities that travel gives our daughter are well worth it. Even though she’s diabetic? Especially because she’s diabetic. Because she needs to see that she has no boundaries in this world, she can do anything, go anywhere – it just takes a little forethought.

Please feel free to comment and leave any tips or tricks on travelling as as diabetic/with a diabetic child. We all need to share the info we learn along the way!

Terry Fox Run 2019

As some of you may know, Sophie (and us, her parents, by default) does the Terry Fox Run every year.
(If you’re not from Canada and don’t know who Terry Fox is or why we run for him every year, click here for his amazing story).

Thanks to generous family members sponsoring her, Sophie has raised thousands for cancer research since 2013 when she first started her annual run. This year would be her 7th year running.
The Terry Fox Run is held all over the world, but we looked it up and there is no run in England this year. We couldn’t let a year go by without running for Terry, and Sophie didn’t want to miss it!
So we decided to take it upon ourselves to do it solo – but also make it spectacular! Sophie put out the call for donations and raised $475 CDN this year….

….And then we went to Stonehenge…..

At the start of the 2km walk to the stones

Stonehenge is about an hour’s drive from us in Bristol. We made plans to do this on September 15, the day that Terry Fox Runs are held all across Canada. We would have done this rain or shine, but were blessed with gorgeous weather the day-of.

We bought an annual family pass to English Heritage (https://www.english-heritage.org.uk) because with this pass, we get admission to hundreds of sites across England, and (due to a small discount for Eric being in the Forces) it pays for itself within 2 visits to larger sites such as Stonehenge and Tintagel Castle. With this pass and advanced-booking, we got to skip the general admission line and get in much faster, as well as get free audio tours, and free parking.

So back to the Terry Fox Run. Eric did it with Sophie, as he does every year. Due to my MS, I can’t walk that far (1 km uninterrupted is usually my max). So I took the shuttle bus to the stones while they walked and I met them there. But Eric took photos of the walk and I got photos of them nearing the finish line!

Walking through the fields to the stones
That’s them coming across
And here they come up to the ‘finish line’ (ie, the bench I was sitting on waiting for them)

After their ‘official’ walk to the stones, we then got to go see Stonehenge, which is a bit of a walk in itself! (Well, I was tired from it!)

Omnipod insulin pump on full display— Type 1s walking for cancer survivors!!

Right when we were halfway around the stones, we hear Sophie’s Dexcom alarm. She was going low (despite us carb-loading her before the walk with a £3 granola bar from the snack shop in the visitor’s centre!). Luckily, we’ve always got oodles of bars and low treatments on hand (she has some in her bag and I have extras in mine, Eric carries some on his key-chain). She had a granola bar and a few dextrose candies, suspended her insulin for 30 minutes, and she eventually got back up to a better level.
Sophie is in the habit of apologising for having to make us all stop and tend to her as she gets things out of her bag, fiddles with her devices, etc. We always reassure her and have patience. It’s not her fault, diabetes isn’t her fault. We are never mad that she’s gone low or needs medical attention! Even if it is an inopportune moment or time, we’re all okay with taking the time to step out of the way at Stonehenge, sit down on the grass, and tend to her.

Smiles once the BG is stabilising at a healthy level


After our time at Stonehenge we went to lunch and then decided to go to Salisbury to see the grand cathedral, since it was so close and such a beautiful day.

Britain’s tallest spire


Salisbury is a medieval city built around this stunning, huge cathedral. The cathedral houses an original copy of the 1215 Magna Carta (one of only 4). We viewed it – it looked old and indecipherable (my ancient Latin is pretty rusty). But I guess I can say I’ve seen it now.

Can’t take photos of the Magna Carta, but this is the beautiful Chapter House where it is kept


What impressed me more, is that the church also has the world’s oldest working mechanical clock, in use since 1386. There we were, watching it tick away, as it had over 4.4 billion times.

Sophie, with the clock behind her.
Sophie in front of the church Close

The town of Salisbury was adorable too, with bunting everywhere and medieval highlights throughout. We could have stayed for hours or even days, but it was getting late and we needed to start getting back toward Bristol for supper, as it was a school night and we were all getting quite tired from our busy day.



I’m hoping that next year maybe there will be enough interest from other Canadians posted here in the UK for me to organise a Terry Fox Run myself for everyone. They do it at the detachment in Germany and Brussels, but this year I didn’t have it in me to do so soon after moving. But Terry Fox wasn’t in it for the fanfare and the big fame – he just wanted people to do what they could – and I think we helped Sophie honour his memory this year and do the name Terry Fox proud.

Thanks to all who donated to her campaign this year and if you missed it but still want to donate to this amazing charity, you can do so here: http://www.terryfox.ca/sophiepoulin .


Day trip to London

We had to go to Ruislip (just north of London) where the Canadian military detachment is for Eric’s in-clearance (yes, they said he had to bring the whole family!) so we decided to make a trip of it and go to London for the day!

Unfortunately, it turned out to be a record-breaking hot day (33.5°C) and we were just melting!

Taken at 7am waiting for the train to London while we were still fresh-faced!

What to do with only 1 day in London? Well Sophie’s never been, Eric has lived here for a few months, and I’ve visited for days here and there. We know we’re going to be back a lot in the next 3 years and have a lot of opportunity to see everything we want and it didn’t need to be done all at once. So we decided to give Sophie a tour so she could get her bearings and see and decide just what it was that she wanted to be doing in those future visits, help her build her bucket list.

Sophie enjoyed the view

We took one of the Hop-on, hop-off bus tours. I always find these a good value in a big, new, city where I’m looking to hit all the tourist hot spots in a day or two (you can usually buy 1- or 2-day passes for these tours). We look for a tour that has a lot of buses (that run frequently), that have more buses with live commentary rather than just recordings (it’s always more fun to hear anecdotes from someone who’s been living there their whole life), and tours that have more than one line (the one we chose had 4 lines that criss-crossed the city plus a river boat we could use that we just never had the chance to). We also picked our company based on who went close to our hotel. Then we pre-paid for our tickets online. This saved us money, but also a lot of time when we wanted to join the tour.

We spent the first little bit touring around. We had a great guide who was informative, funny, and personable. I’m not one of those people to take many photos from a moving bus, but here:

Big Ben (and its tower) are encased in scaffolding for the next few years…. It sort of ruins the skyline of London, but it’s what you gotta deal with in order to preserve these things….
Going across Tower Bridge

We took the bus to the Tower of London and hopped off. We also pre-purchased tickets to the Tower so that we could save a few pounds but also avoid the lines.

Just when we got to the Tower. A lady asked Eric to take their family’s photo and he obliged. Then she insisted she take ours because “this lighting is terrific!”. She was right.

It was starting to get hot by now. The sun was baking. We had dropped our suitcases off at the hotel and they put our main insulin supply in the fridge for us, but Sophie’s small diabetic backpack had a spare vial of insulin in it as well. We don’t have a Frio case at all or any sort of cooler, as we haven’t got around to getting one yet. If you’re soon about to use the insulin, it can stay at room temperature up to 30 days. But insulin can never be frozen and never go over 30°C or it will be denatured. Well, in the direct sunlight, it was well over 30°…. We tried a while to always hold the bag in the shade, looking a little ridiculous as we moved about, but in the end we had to admit that there’s no way we can test if that insulin is still good, apart from a few bolus injections and Sophie won’t allow that. We can’t risk filling a 3-day pump with bad insulin and then having to discard the whole pump once we realise it’s not working.

So anyway, we got to the Tower and it was hot. And then we saw the poor Yeoman Warder…

He deserved a medal for this…

He said in the beginning that he didn’t want to hear us complain about the heat, and he was right. When the weather is bad (rain, etc) they shorten the tours from 1hr to 1/2-hr and he did for us too. They just couldn’t have everyone standing around in the heat that long, guests included.

But it was a lovely tour and we learned a lot about the Tower of London. Sophie and Eric went in and up the Tower itself. We saw the jewels, we walked the ramparts, and we had lunch! As we were leaving, another family came to say hi, just because they’d seen Sophie’s Dexcom and were a fellow T1 family. They had a little boy on the Dexcom and Omnipod and they said they just had to say hi to another T1 family on holiday! I think it’s so nice when someone does that and I do it myself, but Sophie’s still shy about it. Yet, she is upset if we don’t, though. (Tweens, amiright?)

Tower bridge from the ramparts

After our time at the Tower, we hopped back on to a bus and decided to head towards King’s Cross station. This was a surprise for Sophie. Her 11th birthday is in a week and a half and well, we really didn’t know what to get her. So since she is a massive Harry Potter fan, we said we’d take her to platform 9-3/4. I, personally, am not a fan, so it was all Greek to me, but seeing her so excited made me very happy too. She got her photo taken and then we took her to the store there and we said, pick out what you want, we’ll get it for your birthday! Her face was priceless.

The professional photo we bought

Sophie bought that Ravenclaw scarf (100% Scottish lambswool made by the same company who made the original scarves worn in the movies) and a Ravenclaw hairbow. She’s a happy girl.

By then we were getting tired so we hopped on the bus yet again and just let it tour us back to our hotel. We got to see more of London and then crash in our air-conditioned room. (And I mean crash).

Me, in front of a London city-scape, looking hot, tired, and deshevelled.

We went back out again in a bit for an Italian dinner then back to our room. Sophie was due for a pump change – here is where I’m so glad for our ‘bring 3x what we need’ rule. We tried to start up the pump and it didn’t activate properly!!! So we opened a second pump and tried it and held our breath and thankfully all was well. We would have had just enough insulin and one more pod to do it a third time, but barely (with the vial of insulin we now have to throw out due to heat!).

Anyway, pump change in a hotel again but we’re old hat at it now and it eventually went well. We have already ordered a Frio wallet to be delivered later this week for all our future travels to protect our precious insulin!!!

That’s it! That’s our day in London. We had to call it a night and hit the hay so we could be up early to leave for Ruislip at 7am. We were in offices all day long there but felt thoroughly welcomed by everyone at the Canadian detachment and know they genuinely want to help us acclimate and settle in to our home here in England.

London is a beautiful city and we can’t wait to come back on many day and weekend trips over the next few years!

Taken from inside the Tower of London

Type 1 diabetes – and travel

So a lot of the point of this blog is to talk about how we manage travelling around the UK and Europe while still managing the ever-present and domineering type 1 diabetes. I will be making many references to diabetes, what we’re doing, what we use, and why. Before we go any further, I thought some of you may appreciate a quick lesson.

Sophie is an insulin-dependent diabetic (T1D or ‘type 1 diabetic’). What does that mean? And how does it differ from type 2 diabetes?

Most people are well-versed with the idea of type 2 diabetes, as 95% of diabetics in Canada are type 2 – which is often (but not always) related to poor diet, increased body weight, and decreased physical activity – leading to the body’s insulin resistance. Type 2 diabetics are still producing their own insulin in large quantities, but their cells just can’t properly use the insulin that is there.

Type 1 diabetes is an autoimmune disorder wherein the body’s immune system mistakenly attacked the cells in the pancreas that produce insulin. As a result, the body stops making all insulin.

Without insulin, a body cannot use any of the glucose it eats, leaving the glucose in the bloodstream to rise to dangerously high levels. The body is not meant to have so much glucose running freely in the blood so a type 1 diabetic must inject insulin in order to use and store the glucose.
Type 1 diabetes has no known cause. It is not the patient’s fault for having a poor diet or being overweight. Some type 1 diabetics are pro athletes, in peak form, and must still inject insulin.
There is no cure.
(Insulin is not a cure, it is simply a treatment).

Without insulin injections (or without enough insulin), a type-1 diabetic’s body will slowly die of starvation – or go into a condition called diabetic ketoacidosis that can result in coma and eventually death.


Alternatively, if a diabetic takes too much insulin, their blood sugars can go too low. If they are low or going low, it can be remedied with some sugar- a small amount of juice or candy usually.
That sounds simple and it often is, but the danger of going low is more pressing and immediate than the danger of going high. A diabetic can fall low quickly and if they’re too low, they will lose consciousness and not be able to take sugar by mouth. We always carry a special medication- glucagon– with us which is administered by a needle when the patient is unconscious, and helps blood sugars rise to a safer level. Thankfully, we have never had to use this medication.


So, how do we manage this beast? A few ways:
Sophie wears an insulin pump called an Omnipod . It is a small ‘pod’ stuck directly onto her skin with a tiny cannula injected under the skin that delivers insulin. She wears each pod for about 3 days before changing it for a new one. The pod communicates with its controller via Bluetooth. This pod is programmed to deliver a constant stream of insulin.
However, every time Sophie eats, we need to count the carbohydrates in her food. (Carbohydrates are the part of our food that convert into glucose in our blood). Some of you may be aware of counting carbs for your own diets to lose weight or train, but this must be much more precise. Sophie’s Omnipod is programmed for how much insulin she needs for each gram of carbohydrates consumed. Also, as Sophie grows and heads through puberty, her body’s insulin needs change. We are frequently reprogramming her pod to deliver different amounts/more insulin throughout the day and for each gram of carbs she eats. This keeps us on our toes. We never get too comfortable with diabetes around!

An Omnipod pod – with the formula for insulin drawn on

Along with her Omnipod, Sophie wear’s a continuous glucose monitor (CGM) called a Dexcom. This nifty little device is also worn on her skin with a sensor injected under the skin. It tests her glucose levels every 5 minutes and sends the value via Bluetooth to her mobile phone. Then, she ‘shares’ the information via the internet to our phones (her parents as well as whomever is responsible for her).

What we see on our phones, following her blood sugar (post-breakfast spike)

The Dexcom makes life as a diabetic infinitely easier, as we can set alarms to be notified if she’s been high too long or is going low. Also, it sure makes daily life easier for Sophie! Without Dexcom, she would be poking her finger 10-15 times a day to check her blood sugar on a glucometer. With our current version Dexcom, she only has to poke her finger twice a day to calibrate it.
(But also, she must deal with the insertion process of the Dexcom, which can be hard on her).

So these are the high-tech, amazing devices we use to keep our daughter alive every day. You will see me refer to them often. When we travel, we plan to make good use of both of these devices.
However, anyone who has ever had to visit Apple Support knows that even the most wonderful tech can fail. We’re not willing to gamble with our daughter’s life, so every time we leave the city, we need to pack back-ups, and back-ups to our back-ups. That means we need to pack extra pods and Dexcoms, but we also need to pack everything to go analogue- glucometers to do those 15 fingerpokes a day, and needles for insulin in case the pod fails.
If say, we were in Italy, and Sophie’s Omnipod system failed or was lost, she can’t just ‘make-do’ until we get back to Bristol in a few days or even a few hours. We would immediately need to revert to insulin injections up to 5-6 times a day.
Quite simply, she cannot live without insulin.

So we will have many back-ups packed every time we head out on a trip. The Poulins cannot pack lightly!!! Nope, not anymore!
Dexcom sensors, Omnipods, insulin, emergency sugar treatments, glucometer, ketone meter, glucagon, insulin needles, as well as paraphernalia such as alcohol wipes, needle tips, glucometer strips, adhesives, etc. – – I expect our diabetes bag to be cumbersome, but more necessary than the clothing suitcases.

All this, on top of getting to a foreign country and needing to figure out carbohydrate counts in food. Do you know how to count carbs in a plate of Italian pasta? Or in a French pastry? How many carbs in a German sausage or Hungarian goulash?
This is where the internet will be our best friend. We’ve gotten good at estimating, and will have to get better. There are apps that have good approximations and we sort of pick a number based on a wing and a prayer. Sometimes we’re wrong – she might go high and need extra insulin (if it was at dinnertime, this can make for a very late night for us!). Sometimes she might go low and need a quick juice (or 2 or 3) to get to a healthy, steady level.
We’re really hoping to get better at the guesstimating and coasting while we travel.

And did I mention that physical activity also has a serious effect on blood sugar levels? Activity speeds up our metabolic pathways and makes blood glucose drop. For example, swimming makes her levels drop like a stone. Walking makes it drop slow and steadily. When travelling, we will always need to keep in mind what we’re planning to do after eating, in order to ensure she gets a correct insulin dose.

You may think all of this sounds like a lot, but I assure you, it’s only drop in the water. We’ve had days (weeks!) of diabetes education by nurses and doctors and as well we’ve been living with this for almost a year and we still feel like we don’t know enough. I’m only trying to give you a very, very, basic idea of what living with T1D entails. As I write this blog, I hope to teach the uninitiated as well as help other T1D parents out there living with it – maybe pondering a trip abroad with their kiddos and overwhelmed with the idea.

Diabetes can definitely be overwhelming at times. It may be hard to live with. It may be scary to think of going outside our comfort zone by moving to the other side of the world and travelling a lot…. But if living with chronic disease teaches us anything it’s that life is meant to be lived! Stop waiting for tomorrow, start appreciating your todays.

We may go crazy at times, but we’ve been given this amazing opportunity, and we plan to make full use of it! Our daughter may have type 1 diabetes, but she’s also going to have a broad view of this world. She’s going to have friends in every corner of the globe.

She’s going to know that diabetes will never hold her back.

Preparing for our house-hunting trip…

What a relief!

Well, here in Canada, our house has SOLD and we’re now days away from our house hunting trip. The military sends Eric and me over to Bristol to look at and find a suitable house, then hopefully get a lease signed etc. We can also take this time to set up banking, look at schools, check in to Eric’s new office, and explore the area.

In the last few weeks whenever I’ve told people we’re going on this trip, they make some sort of exclamation about how lucky we are, to get a free trip over! Sure, I say, if we didn’t have *so* much work to do in only 5 business days, and if only we didn’t have to leave our T1D daughter behind and hope everything works out okay…

(Okay yes, the military would actually pay to bring her as well, but seeing as its the second-last week of school, and it’s such a long trip and a 8-hour time difference, we thought leaving her at home would actually be the least amount of worry and headache).

So how do new(ish) T1D parents prepare to leave their T1D daughter with her grandparents for 9 days and hope she doesn’t die?
Well, they over-prepare!

Our Everything Binder
Our Everything Binder

We need to remember that my parents are new T1D grandparents too…. and we live in BC and they live in Ontario, so they haven’t had a lot of time to practice! We knew this trip has been coming though, so we had my mom come visit in February for a week and she had an introductory course in diabetic care then.
My mom is also a retired registered nurse, so while diabetes is fairly new to her (she worked in the OR and her patients were usually unconscious) and today’s diabetic tech is definitely new to her – she’s not completely starting at square one.

So I wrote an Everything Binder.

My parents are coming in a few days before we leave, for a crash course/reminder/update in all things diabetic, but I’m still trying to write everything down, including everything routine and everything possible that may come up. Everything.

Examples of pages in the everything binder:
-how to deal with nighttime highs and lows
-how to use Dexcom trend arrows for dosing insulin
-how to best use an extended bolus if they eat out
-a list of good carb-free snacks, if my dad feels like popping to the grocery store
-step-by-step instructions on how to change an Omnipod and Dexcom (though we will change the Dexcom the day before we leave and hope they don’t need to)
-how to calibrate the Dexcom
-how to use glucagon
-codes and passwords for our house (door lock, WiFi, garage)
-a step-by-step guide to our TV and remote control (my parents are 70!)
-a map of the area with places they may need to find highlighted (stores, bank, pharmacy)
-a list of emergency phone numbers – everything from the nurses at the diabetic clinic to some neighbours and even another local T1D parent who could help out


It’s a rather large book of information, and I’m still worried it’s not enough. We will also be on-call 24/7 (all except the time we’re in the air, on our 10-hour-long flights).


In the end, we have to accept that it’s okay if she runs on the high side for the week (higher than we would keep her at), so long as she feels okay and is happy.

In the end, we have to accept that our daughter is almost 11 and smart as a whip, and can very well do most all of this on her own (including more complicated carb-counting and fractions and math than most adults!).

In the end, we have to accept that it’s okay to let go.


This is pretty terrifying to me, to leave her for the first time as a T1D (we left countless times before diagnosis and never cared!!!), but I know it’s got to be done eventually – may as well be now!

How do you prepare to leave your diabetic children with caregivers for extended periods of time?