Traveling with diabetes somehow always seems to raise the hairs on the back of my neck -- despite the fact that I've rarely had any serious mishaps. Still, the idea always makes me nervously expect that something will go wrong (Murphy's Law, right?)
Today, I'm very excited to be heading out to Las Vegas for the first-ever Diabetes UnConference, along with almost 100 friends from the D-Community! Given that it's Friday the 13th for the second month in a row, I'm hoping none of that superstitious bad luck materializes...
Since Indianapolis (where I live) isn't a exactly a travel hub and therefore doesn't offer a direct flight, I'm flying out of Detroit to save some time and money. As that's the area I'm originally from, it works out well because after the five-hour drive up from Indy on Thursday, I got to stay the night with my parents in the Detroit suburbs, before heading to the airport. It'll be the same drill early next week, when I fly back to Detroit and then drive home.
Superstition and a few crazy examples aside, travel for me has never been a huge thing when it comes to my diabetes. But a trip like this is always a good incentive to revisit the "what ifs..." and the many resources, including this Diabetes Advocates post from 2013 and this recent Insulin Nation checklist. But most of it's common sense really, and I think hearing first-hand stories is the best way to... travel. :)
Airport Security with Diabetes
For the first time ever, I'm utilizing the TSA Cares program that allows me to have a Passenger Support specialist meet me at the security checkpoint. That's supposed to make the process go smoothly for people with disabilities and medical conditions. Not that I need the accompaniment, but I'm curious about the program and want to experience it myself so I can let others know whether it's worth checking out for their own travels.
I called the contact number a few days ago, and a friendly customer service rep named Brandon took my info, and then explained that I'm supposed to receive a call or email telling me when and where the TSA rep is supposed to meet me at the Detroit airport. If I don't hear from them, I should inform the TSA folks at the checkpoint that I've arranged this ahead of time, and they should put the wheels in motion. Hmm, that sounds like I may be waiting around a bit more than usual even...
Typically, I arrive an hour or two before my flight's set to board and I keep my insulin pump and CGM on me; I opt out of the full-body scanner to get a pat down instead. Despite sometimes hearing from TSA that it's OK to go through that with medical devices, I don't trust it and tend to go for the cautious approach. I keep my pump, CGM and meter case with my carry-on supplies together, putting them in the bin along with my shoes and other items. I do carry a note from my endo in my meter case, clearly stating that I should be allowed to carry all of my D-supplies on my person, but I've never needed to present that.
After my pat down (which I'm not bothered by), in which I tell my new screening friend where my infusion site and sensor are, they swab the pump and my hands for any dangerous residue. Only once have I been told that there were traces of EXPLOSIVES (!) detected on my insulin pump... but I was aware that could happen, and the TSA was cool and relaxed about it given the medical device at play. They correctly figured out that I wasn't a danger.
This week I expect all of that airport security routine to be pretty much the same, except there will be a nice Passenger Support Specialist there with me.
I'm lucky in that TSA has always treated me with respect and consideration when going through airport security, and my only observations have been that sometimes the whole process seems disorganized and not consistent from airport to airport. Still, it's always gone off without a glitch, except maybe that one time when I was trying to opt for a pat down and TSA tried to argue with me about it. But that was one isolated, grumpy set of people who probably hadn't had enough coffee so early in the morning, IMHO.
In the Air
When I'm on the plane, I've found that D typically doesn't impact much of my sky experience, either. Yes, I do make sure to reserve a good seat so that my CGM sensor isn't exposed to an aisle where people or beverage carts could knock it off. And yes, I do now follow this sage advice from DOC friend Melissa Lee about disconnecting my insulin pump during takeoff and landing to avoid bubbles in the tubing. I usually plan to have my meter case and glucose tabs handy at the top of my bag, in case I need quick access and don't have to rustle through my bag to find them.
I do have a couple extra infusion set and supply extras on hand in my carry-on, but all the rest of my backup supplies and extra insulin, as well as a bottle of glucose tabs, are in my leather-strapped Chaps case inside my suitcase. I try to take this as a carry-on when possible, but seems like most of the time, I'm asked to check it anyhow. Anything I need quickly is right there with me, and diabetes isn't on my mind most of the time during the travel. Instead, I'm usually more concerned about my flight times, WiFi access, and fellow passenger personalities than my D.
My International Highs and Lows
Of course, this Vegas trip is nothing compared to my recent trip to the Dominican Republic a few weeks ago. That brought a whole new adventure in D-travel that I'd never faced before.
It was my first-ever international trip outside of adjacent countries like Mexico and Canada, and I had to get my head around differences like the fact that, even in mid-February, it hit almost 90 degrees with 90% humidity in the Dominican Republic resort community of Punta Cana. So, a big concern going in was making sure my insulin wouldn't overheat.
Yes, I do own a Frio cool case. But I decided ahead of time I just didn't want to fuss with having to soak it, so I went for an alternative: I only took one bottle, and kept it in the hotel room mini-fridge.
I also only filled my pump reservoir up each time about a third of the way, so just in case it spoiled, I'd still have the rest of my vial. In addition, while out by the pool and ocean, I often left my pump in the room, chilling in the cool air-conditioning until I came back to make corrections.
And since I was wearing my Dexcom G4 CGM, I didn't feel the need to do mass amounts of fingerstick tests.
Overall, I was happy with my tropical blood sugars while overseas:
See that palm tree there, reflected on the Dexcom receiver -- Yay, tropical blood sugars!!
Unfortunately, a stomach bug struck the last day messed everything up. I had trouble eating or drinking anything, and my BGs hovered in the 200s for most of that last day and our travel day home. I decided to not wear my pump traveling home, in part because I didn't want to take the risk of it slowing us down through international airport security, so instead I opted for multiple injections of Humalog every few hours (not a problem for me personally).
And then things got messy: I just know I'd grabbed my insulin and packed it in my meter case before heading to the airport. But somehow, it disappeared and I only discovered this on the plane, about 30 minutes before departing (after a two-hour delay). Long story short: I panicked as I didn't have insulin for close to a full day, but managed to not go into DKA and got some emergency insulin immediately once we were back in the States.
The silly end to this story is that I ended up finding the "missing" meter case once I got home. The damn case was buried in the bottom of my backpack, hiding underneath books. I was so mad and frustrated at myself and the situation. I guess packing only one vial of insulin was not the best idea...
It was a rough experience, but I survived. And I came out a little wiser about the need for taking backup supplies, and taking that Frio case even if I didn't want to.
Now, as I head to Vegas for the first Diabetes UnConference, I'm happy to at least be staying in States where I have easy access to replacement supplies if needed (the room will be full of potential donors!).
I promise to report back -- keep your eye on our Twitter feed for updates on my experience with that TSA Cares/Passenger Support Specialist program.
So, what about you, DOC friends: Any D-travel tips snafus you care to share?