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Travelling to USA 1st time with pump

Discussion in 'Insulin Pump Forum' started by Riri, Nov 9, 2014.

  1. Riri

    Riri Type 1 · Well-Known Member

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    Hi, I have previously commented/asked for advice on threads regarding travel. Truth is I'm really stressing out about going to Florida next Sunday as I'm scared how my pump will function on the long flight and with the change in the hour when I get there. Are there any seasoned travellers out there who would like to try and offer me some reassurance/advice. I'm hoping if I hear how others cope I'll calm down a bit !
     
  2. Dazza1984

    Dazza1984 Type 1 · Well-Known Member

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    Hey Riri,

    Well, I am not on a pump but do inject insulin. I found the trick is a slow transition to the time zones; couple of hours each day. Now, Florida is 5hrs ahead of the UK so this isn't a big jump really. It is safer for you to allow ur sugars to go just that little bit higher for journey and the settling in. Take plenty of snacks also.

    When do you fly in relation to meals? Do you get one on the plane?

    D
     
  3. Riri

    Riri Type 1 · Well-Known Member

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    Thanks very much for response. Yes, we fly midday so will get a meal on board. Due to land in Florida about 4.30 in the afternoon. I had read someone on here who changed their pump time straight away the next day but I'm thinking I'll try the more gradual approach as you say. I always change the hours forward 2 hours when in Greece so I may do 2 hours on day 1 and then 3 hours a few days later. Oh god - it's all so confusing!!
     
  4. superskye

    superskye Type 1 · Member

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    My go-to practice for flying half way around the world (which I loosely define as any trip taking more than 18 hours one-way, or crossing more than 4 timezones):

    Make sure I have vial of insulin and syringes in easy access location in carry-on bag, not because I've ever needed them mid-flight, but because it makes me feel more like I've taken all reasonable steps to making sure if something does malfunction, my backup plan is ready to execute at a moments notice.

    Write down my standard pump settings, and leave them in my kit. (Which I should do anyway, but I often don't until I'm packing for a trip.)

    Although some airlines provide decent meals, I've encountered some pretty lousy food over the years so I bring enough food to double as lunch (or dinner, or whatever) to eat while in transit, in addition to the standard arsenal of emergency snacks. This regularly means half of my bag is packed full of food, and I only eat about half of it, but thats more comfortable for me than having to eat whatever random food anomaly the airlines are serving.

    Especially while in the air, check, check and check again; correct as needed; repeat often. I tend to check every hour or two (unless I'm sleeping), and immediately before landing. I also often eat a snack before getting off the plane regardless of my blood sugar because walking all over an airport has a tendency to drop my BG fast. Both in the air, and in an airport, I run intentionally a little high so I have some room for error. I don't generally put in a full correction until I've reached my final destination (like the hotel), although I do make smaller adjustments to try to avoid getting too high also. This is what I attempt at least, it seldom works as gracefully as I hope!

    Time change-wise, because I have different basal rates set for night and day, it works best for me to adjust the time on the pump according to what I'm doing, regardless of what the clock says. When I go to bed, I adjust my pump time to 11pm since thats when my lower night basal rate starts. When I get up the next day, regardless of the actual time wherever I am, I change my pump to 7am, since thats when my morning rates kick in. After a day or two I find that I'm getting up and going to bed per normal-to-the-timezone-I'm-in so I generally only have to do this once or twice. If you have different basal rates for different times of day, try to match them up to your body instead of a clock. If you have a single basal rate, it shouldn't matter what the time on your pump is.

    There's all sorts of precautions and planning for "what ifs" you can find on the internet, but what I've found is that ultimately if I threw a few snacks, a couple syringes, and a good book or two in a bag, I'd be all set for 99% of what happens while traveling. Sure, maybe having the perfect travel pillow and my favorite no-leak waterbottle and some headphones will make it more comfortable, but I don't think diabetes-wise at least I've run into anything besides an unexpected low (which I easily fixed with the arsenal of snacks I carry for just such reasons) or an occasional stubborn high (which nearly always corrects to normal once I reach my destination). There's lots of opinions on ways to travel, and ways to travel with diabetes, and things you must take and should take and need and whatnot, but for the most part, assume that it'll be a regular day, you'll need all the regular stuff, and then bring a couple extra test strips and snacks and you'll be fine. Of course you should have a "backup" plan, but you should have one of those while you're home too. Its easy to stress out over all the 'what ifs', but a lot of them are no bigger of a deal mid-flight than at home!

    (What if your pump suddenly up and dies mid-flight? You check your blood sugar and correct via syringe as necessary; when you get to your hotel you call your pump manufacturer and they overnight you a replacement. What if you get low? You eat a snack. What if you hate airplane chicken? Eat everything else, and a snack from your stash. What if your infusion set pulls out mid flight? You put in a new one when its convenient, unless you've just eaten and miss a meal bolus, you'll be fine for an hour or two unconnected in case it isn't feasible to leave your seat. What if you get stubborn highs? Keep making small corrections, use a syringe if you keep getting higher. If you want to replace a site mid-flight, use the bathroom, but set your kit in the sink so it doesn't roll off the counter. Remember you can replace just the actual infusion set, you don't have to change the tubing or reservoir at the same time, save those for when you're on solid ground and have elbow room.)

    Happy travels!
     
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  5. Riri

    Riri Type 1 · Well-Known Member

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    Great reply and lots of sound and sensible advice thanks. Not sure if I'm quite understanding the time thing on the pump. I have 12 different basal rates through day and night and there is 1 period of about four hours between eight and midnight where they increase quite a bit. I think it's that time I'm most worried about. Is there a way I can do another profile which will take into account the hours difference? My brain us hurting thinking about it!!!
     
  6. superskye

    superskye Type 1 · Member

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    If you get to your destination and immediately adopt life at the new timezone, I wouldn't worry about it at all!

    However, I don't ever manage anything that graceful, and I usually end up going to bed at 6pm or 4am or something equally abnormal, so I try to adjust my pump such that when I do other "morning" activities (wake up, eat breakfast, etc), my pump time is such its using my "morning" settings, and when I act as though its "night", I reset the clock on my pump to whatever time gets me the "night" settings.

    Mentally translate your pump times to general activities.. .say the "lunch" settings run from noon to 2, the "sleeping" settings from midnight to 8am, etc. and set the clock the pump according to what appropriate activity you're actually doing at the time. If you're eating lunch, change the clock to noon (or whatever time you normally eat lunch), regardless of what time it is. If you're heading to bed, set the clock to midnight (or whatever time you normally to go bed), even if that's not reality. It shouldn't take but a day or two before you're mostly on schedule with the new place and everything falls into place naturally, without re-setting the time on your pump every couple hours.

    In your case, it sounds like an "after dinner but before bedtime" setting is your most variable, so if you end up eating dinner at 3pm and going to bed at 7 in reality (assume bad jet lag), you'd adjust the time on your pump such that it was giving you the higher basal after dinner, regardless of the actual time in either your destination or home time zones. Using that example, when you finished dinner, you'd tell your pump that it was 8pm (that would have your "after dinner" settings) regardless of reality. When you went to bed, (if it wasn't already close) you'd set your pump to midnight for the "night" settings.

    I would think that if you didn't have big changes between your other basal rates, that it would be easy enough to set a two-only basal rate program to simplify a little, so a 8pm-12am and then one that averaged out the other settings for the remaining 20 hours in a day, because by far and away biggest the issue when crossing many time zones is that your head thinks its one timezone, your stomach might be in another, and your metabolism and blood sugar pick yet a third time zone. Trying to get them all lined up can be challenging, and since you're on vacation you're probably eating unusual things, carb counting isn't as tidy, and probably walking either way more than usual or way less, so your blood sugars gonna be hit and miss anyway and the basal changes not lining up for the first few days probably isn't that big a deal!
     
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  7. Riri

    Riri Type 1 · Well-Known Member

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    Well I've made it to the end of the fortnight and on the whole things have been fine. I switched 2 hrs back on the plane just before we landed, a further 1 hour during the first night and 2 hours the next day. By day 3 my pump and meter were on USA time and my body had adjusted quite seamlessly really. I've had a few hypos (mainly due to shopping) and a few 'high' high numbers. We swam with manatees in Crystal River. It had been cold and raining the day before and we were swimming at 6.15am. By the time I got out if the water I was freezing and couldn't stop shivering. Took my BS - 18.7!! Think it was a combo of no breccy and the cold. It was well worth it though as several of these gentle giants swam up to us and played around about us. Apparently the cold and rain had encouraged them to swim up from the gulf and into the 'warmer' waters of the crystal river refuge. Such a privilege to swim with them as there are only 4000 left in the wild. So holiday almost over and back to sunny wales tomorrow.
     
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  8. ElyDave

    ElyDave Type 1 · Well-Known Member

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    I normally reset my watch to the destination time when I get on the plane. Last time I flew to Trinidad for work was my firts with the pump and I changed the pump time by four out of the 5 hours at that point as well.

    Carried snacks, pens, wrote down the pump settings etc, all spare insulin, infusion sets, test strips and so on within my hand luggage and enough within easy reach.

    That worked OK for me, and I did the remaining 1 hour adjustment the following morning. I'm assuming the 4-hour rule is to account for your body not adjusting immediately so the diurnal/nocturnal patterns would not ahev adjusted if you did all the change at once.

    To be honest my bigest trepidation on international flights is that where English is not the first language, I'm going to struggle to explain "I have a medical device that can't be X-Rayed" at security. So far though, both Trinidad and Tunisia presented no real problems. Most scrutiny at Paris CDG, along with some odd looks.
     
  9. noblehead

    noblehead Type 1 · Guru
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    Sounds like you had a wonderful time Riri :)
     
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