In a few days, our family is leaving on a trip halfway around and down toward the bottom of the world—my Mom is taking us on a safari in South Africa to mark her seventieth birthday. Most of me can’t wait for the trip. But the diabetes-mom part of me is anxious. What if I forget some of Bisi’s diabetes supplies? What if they get lost or stolen? What if she gets sick while we’re gone? How much of a toll will it take on her A1C for us to have so little control over what she eats for almost three weeks? (When we’re at home and Mark and I are in control of what we serve Bisi, her blood sugars are good. When we’re out and about and she’s choosing from menus offering chicken nuggets, fries, and ice cream…not so much.)
The list of anxieties goes on. In fact, my mom picked South Africa as a destination because, of the countries in Africa, it has some of the best and most accessible medical care. I checked in with Bisi’s diabetes nurse for her advice on the trip. She mentioned a list of things that can throw someone’s blood sugar off: a long plane trip, a time change, the stress of travel, different food, illness. Her advice: “Check her blood sugar often, and accept the fact that her numbers are going to be a little wacky.” On planes specifically, she said to be cautious about bolusing, since last time we flew Bisi ended up in the low 40s (for no apparent reason) by the time we were picking up our rental car. Luckily, she recognized she was low and asked to be tested, since it wasn’t a time I normally would have checked her. After reading Melissa Lee’s piece on air bubbles in insulin pumps while flying, I wondered if Bisi’s low was caused by this phenomenon. Maybe this is something pump makers and doctors should warn their patients about? At any rate, it will be good to be doing this trip, which involves many flights, with a CGM.
Aside from the precautions all four of us will take for the trip—malaria pills, typhoid and hepatitis vaccinations, bringing along antibiotics and pedialyte packets just in case we get an intestinal bug—for Bisi we have also gotten a prescription for Zofran, an anti-nausea drug in case she starts throwing up and we can’t control it. Though it’s now wintertime in South Africa, I also got a Frio, a water-activated insulin cooling pack so we don’t need to rely on refrigeration. And I’m planning on bringing a range of light-weight reliable snacks to have on hand, along with some powdered sweet juice mix, since I doubt we’ll be wanting to carry cartons of juice around. Does anyone have any other advice or useful tips for a trip like this one? If so, please send it along.
I know that the attentions of Bisi and her brother will be focused on the animals we hope to see on the trip—lions, leopards, elephants, meerkats, cheetahs, and more. And I’m hoping that I can get all of my worrying out of the way now, so my focus, too, will be on enjoying and experiencing the journey.