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The last big diabetes conference of the year kicks off next week in Vancouver, and tomorrow, I head over there.
I’ll be popping in and out of here over the week, but Twitter is really where it’s at, so follow along on #WDC2015. I’ll be live tweeting sessions – and everything else that catches my eye! Not on Twitter? You don’t need to be to follow along, but if you want to get involved in the conversations and ask questions, you will need to sign up. (It only takes a few minutes.)
The World Diabetes Comgress always has great consumer representation and you can see from the program – especially the Living with a Diabetes stream – that there are some DOC usual suspects/frequent flyers presenting some great stuff.
As always, it’s a last minute rush to get myself ready, and spend precious time with my precious clan from whom I have been away far too much this year. (And I pledge that once I return from this trip I’ll to do my very best to not see the inside of another aeroplane until February!)
I’m back!
Yes – three weeks of conferencing and travelling and walking and eating and doing not much – and yet so much – have come to a jet-lagged conclusion and I find myself back writing, back at work and, most importantly, back with the kidlet. Which means all is wonderful and I am happy.
So, some diabetes highlights/lowlights from my travels.
This at Dubai airport. Double arrows down, a shitload of insulin on board and a grumpy face. Cleary, a lowlight!
And because I am #NotGoodAtDiabetes, I did it again in Copenhagen:
And in Stockholm.
Stopping in my tracks (and employing the brilliance of Google Translate) after seeing this newspaper on our last night in Stockholm.
Being so grateful for this sight in the press room at EASD in Stockholm…
… because I was low with #ConferenceHypoSyndrome.
Days doing this:
Which meant crazy days of barely needing to bolus as we walked, walked, walked and walked all over cities.
And days of walking meant carb stops of cinnamon buns flecked with cardamom and sprinkled with sugar in Stockholm. And in Copenhagen, no cardamom, but icing drizzled over their tops. And then, once in Paris, flaky, buttery pastries that left tell-tale crumbs down our shirts.
And coffee. Coffee. Coffee. Coffee.
And ice cream because when in Paris, one must Berthillon!
In Paris, I came to an abrupt stop when I saw this:
I went in and spoke to the baker who told me that all the pastries were made using low sugar and low fat recipes. ‘Why?’ I asked him. ‘Why did you start this bakery?’ ‘My father has diabetes. And I do too.‘ He said. ‘And so do I,‘ I told him. We bought a croissant and I was expecting something dry and without the wonderful full flavour of a pastry whose main ingredient is butter and was surprised. It tasted delicious. He knew what he was doing! (Questionable marketing aside!)
There was the crappy night where I realised that my pump was out of insulin and, in my handbag changeover, I had forgotten to throw in my ‘spares bag’, so we needed to leave the jazz gig we had travelled halfway across Copenhagen to hear – before it even began – so that we could get back to the hotel and replenish my insulin stores. A complete #EffingDiabetes moment.
On our way from Copenhagen to Paris, I set off every possible alarm at security and was directed to a security officer. ‘I am wearing a medical device,’ I began, expecting the questions and the confusion and the necessary explanations. ‘An insulin pump? You have diabetes?’ was the reply. My stunned look was met with, ‘My husband wears one.’ And she smiled and sent me on my way.
But then in Dubai, as I was escorted to a sparse, windowless room, my ‘I have diabetes, I am wearing a medical device,’ was met with confusion and questions and the need to find a supervisor and, for the first time ever, a request for the letter from my doctor.
But here’s the thing. When I look back at this time away, it won’t be the hypos or the highs or the diabetes that I remember. It won’t be the times I had to stop to guzzle juice, or check my BGL. It won’t be the numbers or the alarms, warning me to eat something.
It will be the days spent catching up with DOC friends. It will be remembering how, with some of these friends, we made ‘riding the worm’ a thing in Sweden. It will be visiting the ABBA museum, and wandering around cemeteries. It will be afternoons being reacquainted with friends who live half a world away. It will be lounging on the grass at Place des Vosges, and sitting in cafes that we have visited before. It will be thinking about the amazing food – like the incredible beef tartar in Stockholm, and Berthillon’s blood orange sorbet. It will be about the waiter at a local café near our apartment in the Marais who didn’t so much as walk as shimmy and sing our breakfast order back to us. In French.
It will be about all those things. It will never, ever be the diabetes. Ever. And that is just the way it should be.
I had a lovely message today asking me if I was okay. I haven’t posted for a few days and they were wondering if all was fine. Thank you for checking in, J! 
All IS fine. After EASD I have taken a little break and am spending some time in Europe. We’re in Paris, heading back home later this week.
And I’ll be back blogging soon, writing up lots about my time at EASD and the Euro Bloggers Summit. And talking about the food I’ve eaten. And the coffee and wine. And the wonderful DOC friends I’ve seen. And how my diabetes has been behaving. Or otherwise.
See you soon.
This Saturday, I will be heading to the European Association for the Study of Diabetes (EASD) annual meeting – and the Euro Bloggers Summit.
Somewhat serendipitously, Saturday is also Diabetes Victoria’s first ever Travel Well with Diabetes event. Hop over to the Diabetes Victoria blog to read all about it.
In the meantime, I’ll be spending the rest of my week ignoring the fact that I’ve left everything to the last minute (as usual) and haven’t even thought about getting my diabetes stuff organised. I’ll also be ignoring the kidlet’s repeated protestations that her parents are abandoning her and swanning around Europe without her for the fourth time. Diabetes guilt and mother guilt – I need a holiday!
Come fly with me…. (2015 to Orlando)
By the end of this year, I will have travelled overseas five times and interstate heaps more. And over the last few years, have done a lot of travel – for business and pleasure with my family. So with this recent experience under my belt, I decided to enter Diabetogenic into the Top Travel Tips competition run by Virgin Australia and ProBlogger with some tips and tricks that I have learnt on my travels.
Always visit the city public library. (Boston 2015)
‘Travelling with diabetes’ is just ‘travelling’ for me. It’s not like I can leave the diabetes at home – I asked and it refused. I have never considered diabetes as being a reason to not travel. It just takes some planning. But then, so does travel in general!
Steamboat Natchez (New Orleans 2013)
As I have said frequently, diabetes adds an extra degree of difficulty to life. And it is the same with travel. It’s not anything all that significant, just something to consider. So here are my fail-safe tips to travelling not only safely, but also ensuring that a wonderful time is had.
Camels in the Atlas Mountains (Marrakech 2013)
1. Have fun!
Lady Liberty (New York City 2010)
2. Don’t let diabetes be the reason that you don’t travel. And further to that, don’t let diabetes be the reason that you limit your travel to areas you consider ‘safe’.
Shoes in every possible colour combination. (Barcelona 2013)
3. Read points one and two again.
Ice skating in Central Park (New York City 2011)
4. Work out what diabetes supplies you need to take. And then double it. I know: diabetes paraphernalia add bulk and that is a pain – especially when you are trying to travel light (a concept completely alien to me, because: shoes). It is highly likely that you will end up coming back home with a lot of the extras, but that is a far better option compared with trying to work out how to access insulin/pump lines/BGL strips etc. when you are in the middle of a cooking with truffles tour of southern Italy. (Note to self: find and book cooking with truffles tour in southern Italy.)
The magic of a gondola (Venice 2009)
5. And again – I know it’s a pain, but carry things with you rather than packing them away with your stowed luggage. That way, you know where it all is, and the insulin won’t be subject to significant temperature changes. I do know of people who stowed their insulin and it froze, rendering it useless. And someone else whose luggage sat on the taxiway in direct sunlight for 6 hours cooking their insulin. It’s unlikely, but in rare cases, it can happen. You don’t want to be that person!
Mozart everywhere! (Vienna 2012)
6. To declare or not to declare? That is the question. I never walk up to security and announce that I have diabetes. But equally, if necessary, I am happy to answer any questions. I seem to set off security alarms with alarming (!) regularity. By the time my shoes have come off, and any jingly-jangly bracelets are removed, I still frequently set off the alarm. No idea why. At that point, with a pat down on the way, I do point out that I am wearing a couple of medical devices, pointing to them on my body. I am always relaxed about it and willing to pull them out for show and tell. It’s never ever been a problem. Ever. And I don’t assume that the security person will know what I am talking about, so I use simple terminology when explaining what they are for. Often, an interesting conversation ensues!
Dubai 2011
So on that: stuffed in with my travel documents is a letter from my endocrinologist stating that I have diabetes. That letter has never, ever come out – I’ve never been asked. However, it always there, because it is a piece of paper, weighs nothing and the day I decide I don’t need it will be the day I am asked for official documentation to prove my faulty beta cell status.
7. For pump users. Having an insulin pump undoubtedly makes travel easier. No need to do any sorts of tricky calculations for time zones and working out what time to take your long acting insulin. I always have the same procedure: once it’s wheels down at my final destination, I reach for my pump and reset to local time. That’s it! Done! I don’t do it earlier in case of any delays along the way.
Denmark Street for music stores (London 2014)
TAKE A PUMP BACK UP. Most pump companies offer loan pumps. Just make sure you give yourself enough time to organise one.
Oh, Paris. (2008)
Write down your pump settings. I save the settings in my phone and save a copy in the cloud as well. Because I seriously couldn’t tell you my insulin sensitivity factor (or anything else) if my life depended on it. Which it kinda does!
Pumps fail. It’s a reality. It’s crap. And even back up pumps fail. I know the likelihood is small, but it can happen. And if it does, you’ll still need insulin – both basal and bolus. So with that in mind, don’t forget long acting insulin. You can get pre-filled pens if that is your preferred option (don’t forget you’ll need needle tips!). I take syringes because they are easy to use, light, and do the trick!
8. Travel insurance. Don’t leave home without it. And don’t forget to disclose diabetes.
Apartment doorway. (Rome 2012)
9. Medical ID? Some people don’t go to the corner store without their medical ID. Other people rarely, if ever, wear something (guilty as charged). It is an incredibly personal decision as to whether or not you wear something identifying you as someone with a health condition. Think about where you are travelling, if you will be spending periods alone and if you think that having a medical ID would be the best thing for you.
Montmartre (Paris 2013)
The gorgeous seaside Honfleur. (Normandy 2009)
10. Frio packs are great if you are travelling to hot places and you are not sure the availability of a safe fridge. I have found (increasingly) that some hotel rooms don’t even have fridges in them anymore; in Boston, I spent 10 minutes looking for a cleverly hidden fridge in my room at the Hyatt only to realise that there wasn’t one! Having said that, insulin is a lot hardier than our pharmacists would like us to believe, and it won’t disintegrate before your eyes if it’s not refrigerated constantly.
11. One of the best things about travelling is exposure to new foods. Often what you are eating and its nutritional value are a complete mystery. Eat it anyway. You can always correct a high blood sugar or treat a hypo. Don’t let diabetes be the reason to not try the local delicacies.
So much delicious food. Carb counting is your friend!
And while we’re talking food – think about the food available while you are actually in transit. Aeroplane food will never be the best food you will eat. I have never, ever, ever ordered the meal for PWD, but I know others who do and say it’s fine. Don’t think you HAVE to order a special meal just because you have diabetes.
There seem to be some recurring themes in our travel photos. (Coffee everywhere)
I always make sure that I have my own hypo stash while on planes. But don’t worry if you don’t (or if you’ve already munched your way through). You can always get juice on flights. (Don’t forget – on some flights food and drinks are not included in the fee and you will have to pay on board.)
Ampelmann (Berlin 2012)
12. I don’t exercise, so when I travel, I spend the first couple of days low until I remember that I am walking miles and miles and miles. And then remember to alter my basal rates on my pump. (If I was smart, I would do this before the hypos start. I am hoping to become that person one day.) Same thing applies, of course, if you are usually super active and suddenly doing nothing but lying on a lounge chair, reading a book and doing nothing more than waving your hands at a waiter for another cocktail.
13. The Diabetes Online Community (DOC) is your friend! There are people with diabetes EVERYWHERE and we’re a helpful bunch! If you’re in a pickle, social media might just be the thing to connect you with someone to help you out. (And here is the famous Pumpless in Vienna story again.) And even if you are not having a diabetes crisis, travel is a great chance to meet up with people you’ve gotten to know in tweetchats and diabetes discussions online.
Bright (xmas) lights, big city (New York City 2014)
One of my favourite things when travelling is to do just that. I have spent countless hours all over the world getting to know people from the diabetes online community and they have moved from being wonderful cyber friends to truly wonderful in-real-life friends. Diabetes may have connected us, but there is much more that has secured that friendship!
Yankee Stadium (New York City 2013)
14. Shop for diabetes! (Yep, of course there is a shopping angle.) Shopping overseas gives you access to things you may not find at home – especially if you visit markets and fairs. I have found gorgeous little purses for my diabetes supplies while travelling and one of my favourite bags ever was bought on the Rialto Bridge in Venice from a man who makes all the bags in the store. (I justified the purchase by the size of the bag, telling myself it would carry everything I needed for my diabetes for the rest of the trip!)
Rijksmuseum Bibliotheca (Amsterdam 2014)
Travelling should be fun and exciting and enlightening and enriching. It’s a chance to spread your wings, find new places, meet new people and discover new things about yourself. It’s an awesome ride, and diabetes – whether you like it or not – is there with you. Most of all, remember what I wrote in this post here:
The theory of travelling and diabetes is different for every person and every trip. And every trip I learn something new – and not everything I learn is about diabetes!
We have made a point of visiting somewhere new each year over the last five years.
I accidentally bought an Apple Watch last week.
It was the day before we left for Friends for Life and we were in the Apple Store so Aaron could buy one and then I tried one on and thought about how awesome the Dexcom Share thing is (even if we don’t have it in Australia yet) and convinced myself that the watch was pretty much a medical device and got a little indignant that I couldn’t claim it on my health insurance and justified the purchase by considering the tax I could claim back before heading to Orlando. And then I breathed. (Need help justifying a purchase? Just ask me!)
The Apple Genius pointed out all the features to us and kept focusing on the health apps. I smiled and nodded and stopped listening, because: exercise. I just kept thinking about how cool it would be to take calls on my watch. Like Inspector Gadget.
I set up my watch to do the things that I thought I would use, and decided that I would also set up the activity and health tracker stuff. Gender, weight, height, activity level (low) etc. etc.
Monday was the first day that I actually bothered to check the data. By midday, I was surprised to see that I had done almost 10,000 steps. Somewhere in a part of my mind that is rarely accessed, I remember that we should aim for 10,000 steps a day. I was nearly there! By the end of the day, I had completed nearly 20,000 steps.
I need to admit at this point, that Monday was a travel recovery day for us and we spent it at Disney’s Animal Kingdom, wandering the park and being terrified on roller coaster rides. There was a lot of walking. A. Lot.
The next day, MasterLab kicked off and I spent most of the day sitting in a conference room, walking the long halls to refuel on coffee. My watch started reminding me to move. Every so often, I would feel a gentle pulse on my wrist and this message would flash up:
‘Great,’ I thought. ‘Now my watch is judging me.’
I got to the end of the day and found myself disappointed to see a total of only 9,000 steps – nowhere near the previous day’s activity.
The rest of the week in Orlando saw me regularly checking my steps and doing all I could to make sure that I hit at least 10,000 steps a day; a goal, I am pleased to say, I smashed.
I certainly didn’t get an Apple Watch with the intention of using it as an activity tracker (I have a Fit Bit lying unopened in a cupboard somewhere at home which I could have used had I wanted to do that), but it is a feature that I probably will use sporadically.
But the feature is a good way to check in and see just what I am doing. I’ll be interested to see what my activity is when I get back home and return to normal programming.
And in the meantime, I am waiting, waiting, waiting for Share to be launched in Australia. Because that is a tracking app I am ALL over.
‘Are you here for work?‘ It was just after 7am in LA, and the border security officer looked tired. He studied my passport, holding it up, comparing the photo with the even-more tired-looking, and rather dishevelled, person standing in front of him.
‘Yes. For a conference in Boston.‘ I said, trying to smooth my hair.
‘Oh, the diabetes one?’
‘Yes. That’s right.’ I said. My flight from Melbourne was full of people attending the ADA conference. I know this because I knew half of them. Plus I kept hearing snippets of conversation with ‘diabetes’ being thrown around.
‘My mum (mom!) has diabetes. Type 1. She should go.‘ He said. He flipped through my passport. ‘How long are you here for?’
‘Only for the conference and then three days in New York. I’ll be home in nine days.’
‘That’s not long after travelling so far,’ he said to me.
I smiled. ‘You’re so right. But I’ve left my family home this time. So I don’t really mind only being away for a short time.’
‘Enjoy the conference.’ He stamped my passport and was about to hand it back to me when he looked at me again. ‘Do you have diabetes?’
‘Yes. I do,’ I said. ‘I have type 1. Like your mum.’
‘Do you use a pump?‘ he asked.
‘Yes. And I’m wearing a CGM as well.’
‘My mom needs to talk to you,’ he said. ‘You look healthy. Keep it up.’ He passed me my papers.
‘Thanks. I hope your mum is okay,’ I said, noticing the concerned look on his face – one frequently worn by loved ones of people with diabetes. He nodded and I walked off, heading towards the baggage carousel.
A typical, frantic, ‘I’m so disorganised’ few hours before getting to the airport. But I have insulin. And I have a CGM fastened to my stomach and an insulin pump tucked in my bra. There are pump supplies in my carry on. Anything else I’ve forgotten can be found easily at the other end.
Don’t forget to follow #2015ADA!
Once up on a time (July 2014), in a land far, far away (Vienna), there was a beautiful young woman. We will call her Jo (because that is her name). Jo was visiting Vienna to present at a conference because as well as being beautiful, she is smart and well-respected in her chosen field.
In addition to being beautiful and brainy, Jo also has diabetes (which only increases her beauty and braininess). Her insulin pump is her trusty friend, and together they had made the long trek to Vienna. (On a plane, they didn’t really walk there. Let’s not romanticise this story too much!)
But on their first day in Vienna, her pump went ‘kaputt’, which is German for ‘You’re on your own, I’m not working anymore.’
Jo was, understandably, distressed. A faulty pump would mean reduced intake of crisp apple strudel and schnitzel with noodles. Immediately, Jo got on the phone and called the pump company to let them know what was going on and organise to get a working pump to her.
Of course, it was the middle of the night in Australia, so there was no one at the pump company and she was put through to their international call centre. She was assured that someone would be in touch with her as soon as the Australian office opened the following day.
In the meantime, Jo wondered what else she could do. Who could she call that just might be able to help in the middle of the night? So she pulled out her phone, and in 140 characters or less put out this call for help.
And just like a fairy godmother waving her wand, the DOC came to the rescue!
The next day some DOC people sent tweets, Facebook messages, emails and possibly, but probably not, carrier pigeons to put out the call. Who could help? Who could save this damsel in distress kickass, sassy chick and get her back on a pump?
Enter the team at MySugr who are all too clever and aesthetically blessed for their own good, (seriously – they all look like poster children for….poster children), and the wonderful Marlis, who offered to lend Jo a pump.
Jo jumped on a cream coloured pony in a taxi and took herself to the MySugr HQ, hidden away in the streets of Vienna. She climbed the stairs to meet the woman with whom she’d been connected to help her…get reconnected. Marlis handed Jo a brown paper package tied up with string her spare pump.
This is the moment where Jo and Marlis met.
And at this point, Jo was no longer pumpless in Vienna.
She continued her trip – next stop presenting at a conference in Lisbon. Where she was not pumpless. Where she could eat all the Portuguese tarts she wanted without worry.
And she lived happily ever after.
Now, this is all lovely and the outcome was, indeed, wonderful. But what was going on behind the scenes was not. Time zones are a pain in the behind to manage at the best of times; being in a different country to the one where a pump was issued is going to add a degree of difficulty to getting a replacement pump.
However, Jo faced obstacle after obstacle after obstacle from the people she expected would help her. Because this was not a tick-the-box-cookie-cutter problem, they were unable to provide her a satisfactory solution – a working pump delivered to Vienna. Diabetes is never tick-the-box-cookie-cutter easy. It is difficult, messy, crazy, all over the place!
Jo called Euro offices of the pump company – she was not necessarily expecting the Australian office to courier a new pump to the other side of the world. But everywhere she turned, she was faced with a brick wall.
Except when she turned to the diabetes online community which is made up of wonderful people living difficult, messy, crazy, all over the place diabetes lives.
I have told this story dozens of times and have presented it at conferences both here and overseas. People stop me in conference halls to ask me about it.
And the reason that I share this story – which is not mine, – is because it shows (yet again) the value and power of our community. And it shows that social media can be used to connect people in such meaningful – life saving! – ways.
Breakfast in bed.
Food is one of the most wonderful things in my life. I’ve always felt this way. Julia Child once said ‘People who love to eat are always the best people’, and I think there may be some truth to that! Food is an integral – and central – part of my and my family’s life.
So when we’re away, what and where we eat is of great significance. Before I travel anywhere, I have a list of cafes, restaurants, food trucks, delis etc. to visit. Our days are often planned around where we’ll be eating. (Just the other morning, for example, we started with a visit to a favourite haunt when visiting NYC and the spent the remainder of the morning and most of the afternoon wandering around SoHo, stopping in little boutiques and visiting guitar stores before heading back to our neighbourhood late in the day.)
What is different when we travel is that the balanced, home-cooked meals that are the norm at home are replaced with a far more ad hoc, mixed up meal schedule. This doesn’t mean that nutritious food is ignored completely. It’s just that I’m more open to starting the day with doughnuts. In bed.
And that’s just the beginning….
We’ve recharged our batteries with a snack on the run, downing hot dogs from street vendors. (I do keep thinking that I should prepare myself for some sort of horrendous food poisoning, but it’s not happened. Yet.)
You’ll have to take my word for it; it was delicious!
We’ve whiled aways hours and hours on the rooftop of Eataly with friends sharing antipasto platters, the most amazing porcini fritters, and salumi plates while drinking beer brewed on that very rooftop.
Also at Eataly, we’ve munched pastries slathered with Nutella accompanied by steaming Italian espresso to kick off the day.
We’ve eaten pancakes in diners, hamburgers at burger joints, waffles for breakfast and bagels from…well…anywhere.
And soup – warming, sustaining and full of vegetables and restorative chicken broth – has satisfied my ‘mummy moments’ where I’ve thought we needed a hit of something a little healthy.
We’ve taken shelter from cold, wind, rain and snow in coffee shops, hugging bowls of coffee and hot chocolate to warm our frozen fingers.
We’ve eaten at all hours, walking to Shake Shack for dinner one night just before 11pm, or sneaking into a bar after seeing a Broadway show at nearly midnight for fries with our drinks.
Walking out of MoMA yesterday, we made a beeline to the bright red food truck across the road. Ordering lobster rolls for the three of us, I said to the vendor ‘I’m not even hungry – I just love lobster rolls!’
Anytime we’ve been near 23rd Street, we’ve detoured to Doughnut Plant.
Melbourne latte in Midtown.
We located coffee shops run by Melbourne people and sat in the window drinking lattes tasting like they were made by the barista at our local in Brunswick and munching on perfect ANZAC cookies.
Mimosas are the drink of choice at brunch. So there have been mimosas. With brunch.
We ate zipolli at an Italian restaurant on Mulberry Street after being sent there by Rudy’s from Rudy’s Guitars in SoHo after I told him how sorry I was to have missed my mum’s zipolli this Christmas.
And I have poured Half and Half over and in everything and anything that I could!
Changes in diet always pose challenges when it comes to insulin dosing. Just being somewhere different often means that different ingredients are used for dishes that I am pretty good at guesstimating insulin doses for when home. And it also often plays out that the food we’re eating is more carb heavy than usual.
However, despite the oft-carb-laden food, I’ve managed to work out insulin doses. I’ve worked out when to reduce basal doses if it looks like we are going to spend the day on the run, or increase them if the day is looking to be particularly cruise-y and spent indoors doing not much at all.
Quite often the extra carb intake is offset by the extra exercise. We walk a lot when we’re holidaying. New York is a walking city – even in the cold. The other evening, as the temperature sat near freezing, I walked over 40 blocks from where I’d spent the afternoon catching up with my beautiful DOC friend, Alecia, back to our apartment in Hell’s Kitchen. I didn’t do it because I thought I should walk off the food. I just did it because I like walking around here. Plus I was looking for a new pair of boots.
I would be lying if I told you that there have not been some mishaps. Like the night I over-bolused for my burger and had a horrid hypo that saw me wandering into our daughter’s room before Aaron led me back to bed, pouring orange juice down my throat, following it up with toast and jam.
But for the most part, I’ve simply eaten whatever and dealt with it accordingly.
Have I eaten healthfully the whole time? Hell no!
Have I enjoyed food and eating and sharing meals with friends and family? Yes. Absolutely.
Have I felt guilty for any of my food choices? Not. One. Bit.
Diabetogenic 