Tuesday, August 22, 2017

Weathering the Storm

It couldn't have happened at a worse time. Of course, at a better time I would have no story to tell and it would just have been diabetes rearing its ugly head. Nearing the end of our vacation, the Omnipod PDM (Personal Diabetes Manager) began blinking and beeping a swan song. The PDM is the remote control to pods that run William's insulin pump, a pod stuck to his leg.

No worries, I thought, they can overnight a new PDM. The pod would continue to deliver insulin for his background or basal insulin. We could use injections (I brought a few needles) to bolus for food. This a really good plan if my advice to NEVER suspend basal insulin was heeded. ALWAYS use a temporary suspension which then will turn back on after a given time. (Note: advice to William, follow your own doctor for medical advice.)

Low BG and out on the beach, William had suspended insulin delivery so we had no way to turn the basal back on. And, of course..... I missed the cutoff on an overnight shipment. The PDM would arrive after we left on Saturday (so I had it shipped to home). This meant Thursday through Sunday afternoon, Monday really for the transition on MDI (multiple daily injections, meaning many shots). It just got better and better.

I had brought Lantus, a long acting basal insulin, but would need more needles. I have a stockpile at home but was sure they weren't going to be needed. A quick trip to Walgreens, I could buy all I wanted. But how to transition from pump to MDI and back? After talking both to Scott Benner at Arden's Day and later an endo on call, we worked out a plan. But I'll tell you, we have a new appreciation for our pump. William lamented over his mistake in suspending and loss of his pump, but I assured him it was actually a great thing to have happened. He needed to know how to survive if he suddenly lost his pump. I was here to help, but won't always be. This was a learning opportunity.

Within several hours of no insulin, a person with Type 1 diabetes is in an emergency situation. Traveling with T1D means planning, multiple layers of preparedness, always prepared like a scout. No pump? I've read more than one story of someone that forgot their insulin, had no needles, broke their one bottle, or were not within five hours of a 24 hours pharmacy.

I learned that when traveling and pumping, I will make sure to know about pharmacies in the area. Bring lots of extra needles even if I think we won't need them. Bring basal insulin or at the very least, a prescription for it, knowing that a 24 hour pharmacy is within one hour of stay. Make sure that the very last thing we do is check that insulin is packed and ready. And perhaps know how to go to MDI and back, or have the phone number of endo on call. 

We are happily pumping again. We currently project his A1C (blood glucose levels over last three months) to be a 5.4 (normal is 4.5 to 5.5  for someone without diabetes), but of course, he needs to keep me on my toes, so he is changing his eating and exercise patterns with the beginning of the school year.

This blog is not intended as medical advice but is only our own experiences. Please contact your medical team before making medical decisions.