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!

Caerphilly Castle, Wales

For those of you who didn’t know and haven’t looked at a map, Bristol is right across the River Severn from Wales. Cardiff (the capital of Wales) is only about 25 miles from here. Many people commute between Bristol and Wales every day. Sophie even has classmates who speak Welsh at home with their families! So we thought it was nigh time we ventured west and started exploring Wales!

We first thought of heading to Cardiff Castle, a much more popular tourist attraction; but one of the things we’ve learned by living everywhere is to save some local tourism for when we have visitors. If not, then we not only get tired of touring places we’ve already seen when we take our visitors, but we also get tired of paying for these attractions again and again. Sometimes once you’ve been to an attraction once or twice, you’ve just had enough! So we thought Cardiff Castle would be a fun one to save for when our parents or family visit sometime.

Instead, we saw that not too far from Cardiff was a town called Caerphilly and its claim-to-fame is a large, medieval castle. In fact, Caerphilly castle is the second-largest castle in the UK (second to Windsor Castle).

Caerphilly Castle did not disappoint. In fact, all three of us thoroughly enjoyed it

The castle still has both the outer and inner moat (And they have swans!)
On the bridge over the moat, about to enter the castle

Caerphilly Castle was an excellent tourist attraction. It is a great mix of history and fun. We got 50% off admission due to our English Heritage passes (we get half-price at Welsh and Scottish sites).

One of the first things we encountered was the Dragon’s Lair. It is a beautiful audio and visual attraction that tells us the ancient story of dragons in love at Caerphilly. (Because of course, dragons are inherently attracted to castles). You can read the Cadw Dragon’s Tale here.

Then we took to walking around and exploring. No one can miss the big ‘leaning tower’. This tower once held the kitchen and started falling over in the 17th century but never fully fell over. It now leans more than the Leaning Tower of Pisa.

The above is a wooden statue of the Marquess of Bute, the man who in the 1920s started spending over a hundred thousand pounds of his own money to start restoring the medieval ruins.

Now enjoy the shots of us exploring this awesome castle:

While we were there, we were unable to access a few of the public areas due to a movie filming. I asked what movie and the ticket lady told me it was some Netflix show about King Arthur coming out next year. While we were on the first floor of the main gatehouse, they were filming right below us and we could hear them. We saw actors walking around too. Cool! As I looked around the castle, I couldn’t help but think it really was a perfect location for a movie set!

Sophie in a maze they had at the back, she had a blast going through it.

We spent about 2 hours walking around the castle. Climbing up and down ancient stone circular staircases (that were wet, too! Slippery!) and exploring much of the castle. It was so neat! Then we had a nice picnic lunch on the grounds and then went nuts in the fabulous gift shop – Christmas shopping for my nieces and nephews has started!

This is exactly what we envisioned when planning a move to England – just a random Sunday with no plans and so we were able to hit the road, explore an 800-year-old castle, and be home in about 5 hours total – still with lots of time before supper!
(I keep having to remember to say ‘supper’ and not ‘dinner’, because ‘dinner’ is lunch….. damn upper-Canadian lingo!)
The history and adventure that we can enjoy steps from our house is amazing! We love it!

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 .


We’re officially expats!

Well we’re here! We’ve made it! We got through immigration without an issue and now we’re officially expats- Canadians living in the UK for the next 3 years!

Our flights were pretty good, the only hiccup being delays in Victoria, about 2.5 hours. Luckily, we originally planned for a long layover in Vancouver so we had time to spare. Turns out we ended up with only an hour or so in Vancouver and because it’s such a large airport, by the time we got to our gate, they were just starting boarding. Perfect!

img_20190811_172056039-1
Looking fresh at the beginning of our long flight!

The flight from Vancouver to London is about 9 hours and is an 8-hour time difference – so no matter what, it leaves you messed up. There’s not much you can do to prepare for that and it takes time to get over that.

Wine helps.

This was the longest flight Sophie has ever taken and the furthest she’s ever travelled to date in one-go, so she had endorphins and excitement to keep her going. She’s never been on an intercontinental flight, so she’s never got to experience a real airplane meal (not including the fairly nice ones you can buy on Air Canada domestic flights).

Air plane dinner

We knew that dinner would be served right before we needed to try and sleep, and the only sugar-free drink options for her would be water or caffeinated diet Coke, so we picked up a sugar-free drink in the airport before we boarded (she had the choice of iced tea or diet Sprite). Thinking ahead is usually how to I try to avoid diabetic upset!!
But then dinner came and how to guess how many carbs in this meal? Pasta, a bun, a brownie, and a corn and edamame salad? We just completely guessed. We didn’t guess enough, and had to do a correction later on. We figured it was better to be conservative on that side than to risk lows on the airplane.

Then it came time to land!

Eric showing Sophie the landmarks of London as we fly over
Sophie couldn’t take her eyes off London below us as we descended

And as you know when you approach a new city with new time zone as you land, the pilot lets you know the local time and everyone adjusts their watch (okay, not as much anymore because everyone has cell phones…). We took this time to pull out Sophie’s insulin pump control and adjust the time settings in that.
The timings in an insulin pump are very specific to each individual for every hour in the day. As I’ve explained in the past, she gets a constant drip of insulin throughout the day, as well as doses with each thing she eats. This constant drip dose throughout the day changes up and down based on her body’s insulin needs (as we’ve determined them, with the help of nurses and glucose monitoring). Same with her meal doses- She gets a different dose of insulin with breakfast carbs than she dose at lunch or dinner. This is all because of a lot of trial and error and countless dose adjustment and changes we’ve made over the past 6-9 months. We are always watching her glucose levels and determining her insulin needs and adjusting her insulin pump settings and daily timings, if necessary.

So, we were very nervous about making a drastic 8-hour time change to her insulin pump. We did a lot of reading about how best to do this – we read about changing it an hour a day, eating meals on the origin’s time for a few days, etc. But we found most of these suggestions lent themselves best to the idea of only a 2-4-hour time-change, not a huge 8-hour time-difference.

In the end, we decided to go for the rip-off-the-bandage approach and just change the time in the pump and deal with some wonky blood glucoses for a few days as we all try to get used to the time.

Pushing through!!! Changing those time settings!

We definitely noticed wonky BGs for the first 24 hours, her body didn’t know if it was breakfast or nighttime or what…. but we’re approaching the 48-hour mark and the BGs are already starting to make more sense (as much sense as T1D can ever make in a pubescent girl!)

So now here we are in Bristol!! We pushed through our jet-lag and had a busy first full day, picking up our rental car, picking up the keys to our new house, visiting our new house, and registering at the local doctor’s office. Sophie loves our new ‘local’ (the closest pub to our house) where we went for lunch and we do too.

Sophie can’t take her eyes off the windows while driving around, there’s so much to take in!

We topped off the day by celebrating Sophie’s first diaversary! Yes, one year ago, on 13 August 2018, she was diagnosed with type 1 diabetes. And now here we are! She got to choose dinner (fish & chips with mushy peas) and pick out English chocolate for dessert. It wasn’t a big huge celebration, but we are in a new country and getting to do an awful lot of awesome fun things!

Sophie is enjoying her diaversary chocolate

We still have so much to do- meet the doctor, get referral to the Diabetes Clinic, buy stuff for the house, go get school uniforms for Sophie, set up our mobiles…. the list seems endless.
We’ve received word that our furniture and effects have arrived in England and we’re currently trying to arrange a date for delivery and unpacking- they don’t seem to be in a super hurry to get to us!

So there’s still so much to do to officially make this our home, but we will and we are! The adventure has only begun!

Thanks for bearing with me! Here we go!

Well the past two months’ of blog posts have been what I’ve promised- practice. I needed to learn this platform, figure out how to blog, how to post, and how to ‘run’ a ‘website’ (both terms I use very loosely).

In the past two months, I’ve even struggled with what to write- our life in Canada is pretty mundane and boring, even while preparing to move across this globe, even while living in hotels for the past month.

But now we’re ready to go. We fly to England the day after tomorrow and our adventure truly begins!! Now I hope to start having blog posts worth reading! And I thank the 30-40 of you who have actually been reading up ’til now and giving me enough reason to go on.

We’ve had a few hard goodbyes in the past week or two. Especially for Sophie. But luckily she’s now at the age where she can keep in touch with her friends digitally. If we didn’t get to you for a so-long hug, I’m sorry and don’t take it personally. I truly find it easier to just not have them. We’ll all chat online and I love that I can keep up-to-date on my friends and even their kids on social media. We also live in the military— we’ll all see each other again eventually!!!

I’ll share a handful of pictures of our ‘resort life’ now as we’ve been living in a cool hotel for the past 16 days. Sophie has had a blast swimming every day (which makes her blood glucose fall like crazy— good, if it’s been running high, we just take a quick trip to the pool! If not, she needs to drink some regular Coca-Cola before swimming in order to have high enough blood glucose to swim and sometimes every 20 minutes, too).

Also, check out my Highs and Lows Abroad Instagram below for more frequent photos.

The biggest golf tournament of the year was here on our second day.
Sophie and her bestie playing in ‘ceremony circle’, taken from our balcony on the 5th floor
Taco night with a view
The beautiful pool we’ve spent many hours at

So that’s it. That’s our life in Canada for now. Yes, we’re still here for a couple more days but I’ll be busy packing and saying so-long in person to a last few folks. So this is my last Canadian blog post.

Wish us luck with the long flights and immigration process.

I’ll update when we get to England, probably in the middle of the night when I’m jet-lagged and zombie-like exhausted!

Here comes our next adventure!