Traveling the World With Diabetes: An Interview with Bridget McNulty

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Bridget McNulty is a South African writer and journalist, and a Type 1 diabetic. Her first novel, Strange Nervous Laughter, was published in South Africa in 2007 and released in the USA in May 2009. She has written articles for a number of South African magazines, including ELLE, Real Simple, the Oprah magazine, Psychologies and Woman & Home, and frequently writes about diabetes. In 2008 she was voted one of Cosmopolitan magazine’s Awesome Women, an award extended to 30 South African women who are making a difference in their chosen field and inspiring other women to live their best lives.

Bridget is also a frequent blogger, both on her personal blog which was shortlisted for a South African Blog Award in 2008, and on ThoughtLeader, the Mail and Guardian’s exclusive blogging platform (www.thoughtleader.co.za/bridgetmcnulty).

She was diagnosed with diabetes in 2007 (at the age of 25) and, thanks to Apidra and Lantus insulin, has had excellent control ever since (her HbA1c results for the last year were 5.6 and 5.9). She also works as a champion for diabetes awareness in South Africa.

Bridget is a passionate writer intent on living the truth that people with diabetes can do anything they want to.

Tell us a bit about yourself, including your personal experience with Type 1 diabetes. What was your diagnosis like? How has it affected your life?

Before I was diagnosed with diabetes, I was a baker with a sweet tooth. All my friends (and friends of friends, and people I didn’t even really know) knew me as the girl who threw tea parties, with delicious homebaked goodies. So when I was diagnosed with Type 1 diabetes at 25, I thought there had been some kind of mistake. How could I be diabetic? Who ever heard of a diabetic baker? The irony was too much for me.

Of course, there was no mistake. By the time I was diagnosed, I was so dangerously ill that my doctor told me had I waited another three days I would have been in a coma. In retrospect, I wonder why I waited so long to go to the doctor, but my first novel had just been published (2 weeks before) and I’d been so busy organizing all the online marketing and the launch and juggling that with a full-time job and starting a blog (www.bridgetmcnulty.com) that I thought I was just exhausted and strung-out. I also blame mental confusion, one of the lesser-mentioned symptoms of pre-diagnosis.

Tell us about your trip: what was the inspiration for the journey, where did you go, and what did you hope to accomplish?

When I was first diagnosed, I was sent home with a pile of literature from the hospital. It was, in a word, terrifying. Diabetics are at risk for heart disease, kidney failure, eye problems, amputation – the list went on and on. I remember reading a statistic that said that 70% of amputees are diabetics, and in my head I read the statistic backwards and thought that 70% of diabetics were amputees! I was so scared.

And I understand why it was written like that – they want to scare people into submission. But for me, fear has never been a good motivator. So when my fiancé, Mark Peddle, and I decided we wanted to travel the world, we wanted to do it for a cause, and diabetes seemed the obvious one. Our goal has been to show that just because you’re diabetic doesn’t mean you can’t follow your dreams, that diabetes doesn’t have to stop you doing anything. Inspiration is such a powerful tool, I think, and that’s what we want to say to all diabetics – if you’re in good control, there’s nothing you can’t do.

We traveled for six months, and went to Thailand, Cambodia, Vietnam, Indonesia, Brazil and Argentina, for a month each. We kept a blog (www.justtheplanet.com/sweet-life) along the way and recorded weekly video diaries talking about the highs and lows of travelling with diabetes (http://www.youtube.com/my_playlists?pi=0&ps=20&sf=&sa=0&dm=0&p=8FA15DB9D54E38CF)

And daily video snippets of the Best Moment of the Day

(http://www.youtube.com/my_playlists?pi=0&ps=20&sa=0&dm=0&p=E89995972DACD990)

The idea was for people to be able to follow the journey in a really personal way, and as a result we have a huge body of material all about traveling with diabetes, along with a whole lot of hints and tips about preparing for a journey as a diabetic:

http://www.justtheplanet.com/round-the-world/travelling-with-diabetes/introduction.php

A trip that long takes a lot of planning, even if you don’t have diabetes. Can you tell us a bit about what that process was like?

Seemingly endless! We actually only spent about 9 months planning, but we could easily have taken twice as long… Most of our time, actually, was taken up trying to get sponsorship and getting the word out to diabetic companies about the journey. But there was also a lot of decision making about where to go and for how long and how to get around once we got there and and and.

What’s been interesting is how little of that information we’ve actually used – traveling is very much a thing of the present, and most of our decisions have been made on the road, either based on recommendations from other travelers, or because we realize just how far apart or close together two places are. I think with a good guidebook (that you don’t trust 100%, because all guidebooks are inherently out of date) and an adventurous spirit, not that much planning needs to be done in advance. Apart from who’s going to look after your plants and pay your bills and all that!

How did you get the idea of keeping a blog about your travels as a diabetic? In other words, did the idea for the trip come first? Or were you initially motivated by the idea of doing something adventurous with Type 1?

Mark and I really wanted to travel together, as I said before, but the thought of just being on holiday for 6 months wasn’t that appealing… We both really like using our brains, and we wanted the journey to be more than just a fun trip. We wanted it to have some meaning. And seeing as so many diabetics are wary of traveling (with all the challenges involved), it seemed a natural solution. Mark’s a photographer and I’m a writer (a perfect combination), so we partnered with Just the Planet, the online magazine for independent travelers (www.justtheplanet.com) and it all started coming together.

What were some of the challenges of traveling in Asia and South America with Type 1 diabetes? How did you get your supplies? What problems did you run into? How did you solve them?

We did a lot of research beforehand about how to get my supplies to various parts of the world… and it proved near impossible. Courier companies couldn’t guarantee the insulin would remain cold during transit (it’s a long trip from South Africa), customs was a nightmare and some countries simply didn’t allow unaccompanied medication to cross the border. So we decided to take the plunge and carry 4 months worth of insulin with us. I use insulin pens (most of South Africa does) so space-wise it wasn’t too difficult, I just put them in a small cooler bag. Of course, there were also the needles, and the testing strips and the lancets, but we made space (don’t get me started on packing and repacking every 3 days – what a nightmare!)

The challenges I can narrow down to two: food and heat.

We planned the trip chasing autumn  around the globe – that way, we reasoned, we would miss the terrible heat of summer, but wouldn’t have to deal with packing for winter. Little did we know, South-East Asia has no winter, it’s summer all year long. And although we were traveling in the rainy season, we only really had trouble with the rain once – in Siem Reap, in Cambodia, when we arrived in full flood! Water up to our knees. Not the cleanest city. Not all that hygienic.

But back to the heat. Before we left, I’d had insulin deactivate because of the heat maybe once or twice. Cape Town can get very hot in summer, and I had it in my handbag in the back of my scooter riding around during a heat wave. Dumb mistake.

In six months on the road, I’d say my insulin has deactivated from the heat at least 20 times. It was just so unbelievably hot – in Thailand, in Cambodia, in Vietnam, in Indonesia, even (surprisingly) in Brazil and Argentina. There was no escaping it! Average temperatures of 33 to 40 Celsius in the really hot places, and insulin deactivates at 35C. So it was a challenge, not only because my everyday insulin (that I carry in my bag) kept suddenly expiring and I had no way of knowing until my blood sugar went sky high, but also because my cooler bag (which was supposed to be magical and keep cool for 2 days when frozen, but didn’t, of course) couldn’t stay that cold during long days of traveling. And there were lots of those – 11 hours in an unairconditioned minibus in Java, a full day of bus-hopping in Thailand, overnight on trains in Vietnam. Most of the time I would figure out that the insulin was bad, chuck it out and try a new pen and that would be that. But on one occasion – towards the end of the 4 months – I had four pens in a row that had expired, so for two days I was scary high. It was terrifying. We had just arrived in Bali after a hell of a day of traveling, and nobody stocked my insulin (Apidra and Lantus) or spoke English (I had to get a translator) and I just felt so awful because my blood sugar was so high and I couldn’t get it down. And of course, having to wait two hours in between shots to see if it had worked was torturous!

After 4 months Mark and I went home for 4 days to pick up fresh insulin, so that helped matters, but then we hit Brazil, where averages tend towards the 40C mark, so thank goodness we’re on our way back home again now!

The other challenge was food. I’ve never eaten much Asian food, but I thought that knowing the carbohydrate content of rice and noodles would pretty much be enough. I was wrong. We got served all kinds of crazy foods, that I not only couldn’t identify (some kind of sticky square of white stuff that could be related to rice?), I also couldn’t ask what it was (no English) or relate it to anything I’d ever seen. So we did a lot of guessing. Asia was also tricky because their breakfast is either chicken noodles (no thanks) or white baguettes and egg. Not too bad, except that the bread was completely light and airy, and crazy high in carbs. So it filled me up for all of an hour, and I had to take loads of insulin for it. But that’s one of the things you have to get used to when you’re traveling – not having much choice when it comes to food. If none of the shops stock it, you’re not going to get it. I longed for wholewheat bread and brown rice and cereal that wasn’t sugar-loaded.

And then when we got to South America it was much easier to get recognizable food (hello brown bread!) but other customs were just as tricky. For example, at home I’ll generally eat high-fiber cereal with fruit and milk for breakfast. All over Brazil and Argentina they eat white toast, medialunas (sweetened croissants) and coffee – with a glass of fresh orange juice if you’re lucky. This is GI murder – if anyone ever wants to understand the concept of low versus high GI, eat this breakfast, test two hours later (high) and then an hour after that (low). Not an ideal way to start the day!

Do you have any recommendations — for planning, or for the trip itself — for other Type 1 travelers? What was on your diabetic packing list? What do you know now that you wish you’d known before?

I read up a lot about traveling with diabetes before we left, and compiled info lists (on the website) and prepped myself for difficult diabetic border crossings, but it was actually not a problem at all. It’s good to be informed, but don’t freak yourself out.

I would say that 4 months is too long if you want to take your insulin with you to the hottest countries on earth. Up to 3 months I’d only had the occasional problem, but that 4th month was really, really tough. I wouldn’t wish it on anyone.

Other than that, it’s just the usual:

  • Make sure you always have food on you, because traveling is so unpredictable that at some stage you’re going to end up stranded somewhere for a few hours with no food in sight.
  • Always have something in case you go low (that isn’t juice – my favorite but impossible to take through airports). Just yesterday I went low while standing in an endless customs line – thank goodness I had something to eat, or I would have been stuck for half an hour.
  • Take into account the unusual amount of exercise you’ll probably be doing when you arrive in a new city, and the unusual amount of sitting you’ll be doing on long travel days, and adjust your insulin intake accordingly.
  • Release control over eating a perfect diet. You have to, or you’ll be miserable and keep beating yourself up about ‘cheating’. If there is nothing else to eat but refined white flour products, then that’s what you’re going to eat. Don’t ruin your holiday feeling bad about it.
  • Don’t expect to be in perfect control. Before I left, I would get really bummed when I got a high reading for no reason, or when I went low out of the blue. But when there are so many contributing factors – weather, stress, food, activity, hormones – it’s far more likely that you won’t be in perfect control. Especially seeing as so much of the food will be unfamiliar, so it will be a guessing game. Keep as stable as you can (so you feel well and can enjoy everything) but don’t set unrealistic expectations.

What preparations did you make in case you had an emergency on the road?

 

Bridget and Mark

Mark. I trust him so implicitly, and he knows so much about diabetes (his brother has been a Type 1 for 20 years) that I know he could deal with any situation. I also always had something sweet on me in case of lows, had a copy of my prescription so that we could get more insulin if something happened to mine, and joined IAMAT (the International Association of Medical Assistance for Travelers) which recommends doctors in every corner of the world. They’re free to join, and a great idea – www.iamat.org

And of course I always wear a MedicAlert bracelet.

Tell us a bit more about the trip itself — what were some of its highlights? What was one experience you never anticipated having? 

Wow…. Most difficult question so far! There were so many highlights, it was such a constantly surprising, fulfilling journey. We honestly didn’t know what would happen next. I’ll choose one from each country –

Riding an elephant through the Thai forest

Visiting the ancient ruins of Angkor Wat in Cambodia

Spending a night on a pirate junk in Halong Bay in Vietnam

Scuba diving with turtles in Bali

Flying in a helicopter over Iguassu Falls in Brazil

Horseriding through the pampas at sunset in Argentina.

And one experience I never anticipated having? Getting engaged! Mark took us out in a traditional fishing boat off the coast of Amed (a small village in Bali) at sunset… A volcano silhouetted against the setting sun, fresh mango juice, sunset, ocean, and the most beautiful bamboo ring to propose with. He had bought it in Thailand (4 months earlier) and had a silversmith on the island of Gili Air add in strips of silver to customize it. I love it!

What are some of the most interesting reactions you’ve had from people when they find out that you have Type 1 diabetes?

We did a number of hotel reviews along the way (for Just the Planet – www.justtheplanet.com) which was really interesting, because we got to meet all kinds of different people in these gorgeous luxury hotels. When we arrived at the Raffles Le Royal in Phnom Penh, Cambodia, the marketing manager, Kunihiro, told me that he’d been having all these strange symptoms lately (waking in the middle of the night with an insatiable hunger, always thirsty, funny vision) and had been so surprised to get our email because he thought it might be diabetes. Of course it was (Type 2) and over the few days we stayed at the hotel I gave him a crash course in diabetes, and made him go for a proper check-up. We still keep in touch, and he’s since been officially diagnosed and is on medication and feeling much better. It amazed me how many people we met who knew someone close to them with diabetes, but didn’t know that much about the condition. I did a lot of informal educating along the way!

What advice do you have for other people with diabetes, who might be interested in traveling but who are worried about how to handle the disease on the road?

Just do it! It’s not a disease, it’s a condition, and it’s never going to go away. So unless you want to cheat yourself out of one of life’s most incredible adventures (and all travel is an adventure – even if it’s within your country or somewhere close by), you need to learn how to handle it on the road.

I’d say start easy. Start in your own state, for a day trip. Then a weekend away. Then a week somewhere a couple of hours away. And build up your confidence. The year before Mark and I left, we traveled all over South Africa, getting used to not having choices when it came to meals, and being on the go, and being out of our comfort zone. And then for your first trip overseas, make it a short one – a week or two. It’s really just a different way of handling diabetes, and once you’re used to it traveling will seem as natural as staying at home. As long as you’re well prepared and with someone you trust, there’s no reason for diabetes to hold you back from traveling anywhere (that was why, incidentally, we chose South-East Asia and South America. We wanted to start with the ‘hectic’, unfamiliar countries while we’re still young and full of energy).

What lessons have you gathered from this trip? How do you think the experience will affect you once you’re back home?

 So many! It has been one long learning curve, day to day.

Diabetically, I’ve learnt that I’m a lot more adaptable than I thought I was. That taking care of myself (enough sleep, lots of water, vitamins daily and as healthy a diet as possible) translates directly into how well I feel and how much energy I have. And that there’s no reason for my diabetes to hold me back.

In my relationship, I’ve learned that sharing is all-important (try sharing one computer for 6 months and sharing becomes a key issue!) I’ve learnt that Mark and I make a great team, and that when you work together you can get through anything (even floods and dangerous highs and being homeless!)

And personally, I’ve learned to let go. So much of this journey was about releasing the need to be in control – of what we eat and where we sleep and what happens next. Sometimes you just don’t know, and that’s fine. You have to wait and see what life springs on you, and often it’s completely unexpected, but it always turns out to be just what you needed.

So that’s what I hope to take home with me – this new acceptance of life. There have been times when I’ve thought, “No! This is wrong! What do they mean the train is full? How on earth are we going to sit here for another 8 hours? I. can’t. do. it. It must change!” But it didn’t, and I could do it, and getting upset about it didn’t change anything. I’m hoping this broader perspective stays with me for many years to come… And when it feels like it’s slipping, well, that’s a good excuse to plan another trip!

To find out more about Bridget McNulty, visit www.bridgetmcnulty.com

Photos by: Mark Peddle

Catherine Price is a regular contributor to ASweetLife, she writes the blog The Reluctant Diabetic

Comments (2)

  1. Becca Kantor
    Becca at

    This is such an inspirational interview, Catherine! It covers so many aspects of traveling with diabetes–including logistical problems with which I could definitely identify–as well as highlighting some of Bridget McNulty’s experiences that make traveling worthwhile in spite of the difficulties. By the way, I also really enjoyed reading your recent posts about your own travels.

  2. Thanks once again for sharing this nice stuff.

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