Don’t Let Diabetes Ruin Your Travel Plans!

1. Don’t Let Diabetes Ruin Your Travel Plans! May 17, 2011

2. Vacations and travel are fun!! • Great opportunity to re-energize yourself • Break away from the daily grind & doldrums • Chance for adventures • Spend quality time with friends/family • Time to make some memories • Learn something new • Rest • Fun!!

3. Travel begins as you leave your front door. • Information can apply to: • Short local outings • Weekend getaways • Week long trips and cruises • Exotic, once in a lifetime trips

4. Today’s Diabetes “Cruise” • Captain: Mary Lawrence • Cruise Director: Kathy Haarmann • Travel Mates: Liz Patton, Nancy Trebilcock, Mary Green

5. Customs

6. Port #1 Supply Island

7. Port #2 Tootsieville

8. Port #3 Nutrition Junction

9. Port #4 Disaster Dunes

10. The WORST-CASE SCENARIOSurvival Handbook: Travel • The unexpected usually happens. • Accept the things that are beyond your control. • Always have a contingency plan. • No matter how bad things are, they could be worse. • Don’t respond to the possibility of bad luck or problems with staying home.

11. Travel Issues • 50% of travelers run into problems • Flights are late—28% in December 2010 • Bags are lost—3.1 million baggage reports were filed in 2008 • Reservations are mishandled • Weather is unpredictable • Cars break down • Things happen!

12. Diabetes Issues • Irregular schedules • Inability to control all your food • Extreme amounts of activity • Time zone changes • Increased sensitivity to heat • Limited supplies

13. Worst Case Scenarios—What do you do? • Your purse is stolen from the hook on the bathroom door. It contains all your medications.

14. Worst Case Scenarios—What do you do? • There is a tornado damaging the St. Louis Lambert Airport totally closing the airport. Your flight is cancelled for today and the flights are all full tomorrow. Your arrival home will be delayed by at least 36 hours. You do not think your supply of insulin will last that long.

15. Worst Case Scenarios—What do you do? • Your new Nike walking shoes that you bought just for this trip, have rubbed a blister on foot.

16. Worst Case Scenarios—What do you do? • You get a case of Montezuma’s Revenge and blood sugar’s are running high.

17. Worst Case Scenarios—What do you do? • The plane you are on has a mechanical problem, and you are stuck on the plane with no food service while they are making the repair. You did not eat anticipating a snack lunch on the plane. You are starting to feel hypoglycemic.

18. Worst Case Scenarios—What do you do? • You are having abdominal pain that you have self-diagnosed as an appendicitis attack. You need to go the Emergency Room.

19. Worst Case Scenarios—What do you do? • You are at a Mexican resort for the week. You get your meter out of the bag to test your blood sugar, put in the strip, and the meter does not turn on.

20. Worst Case Scenarios—What do you do? • You usually change out your pump reservoir and set every three days. But you are rushed before dinner and calculate that the insulin will last until tomorrow. You decide to wait and change it in the morning. When you disconnect the next morning to change it, you realize the site is red and very tender to touch.

21. Worst Case Scenarios—What do you do? • You are on a day trip. You planned to eat breakfast and lunch out, but dinner would be at home. You brought medications for the first two meals, but not for dinner. Your car breaks down. You do not know if you can get it fixed today, but you know you will definitely not be home for dinner and will have to grab some food at a small diner.

22. Worst Case Scenarios—What do you do? • You accidentally left your meter in the car while you spend a hot day at an amusement park. When you return to the car and realize your error, you use the control solution and the result is out of range. You decide that your strips have deteriorated and are probably no longer accurate.

23. Worst Case Scenarios—What do you do? • You packed plenty of medications and testing supplies for your trip. You have some supply with you in your purse and the rest are packed in your checked luggage. The airline loses your luggage. As you start your 4th day of vacation, your luggage has still not turned up at your hotel.

24. Worst Case Scenarios—What do you do? • You have two glasses of wine at dinner. After dinner, friends talk you into another glass back at your condo. At 3 a.m. you awaken in a cold sweat and a little confused.

25. Worst Case Scenarios—What do you do? • During a warm summer day you enjoy a lot of hiking and time at the pool in the sun. When you check your blood sugar before dinner it is 280 mg/dl.

26. Identification and Information • ID card or jewelry that identifies you have diabetes • Emergency contact information and your physician phone #’s • List of medications • Brief health history • Prescription labels or letter from MD for the lancets and insulin and needles that you are carrying • TSA notification card

28. TSA Notification Card

29. TSA Screening • Metal detectors, full body scans and enhanced full body pat-down • This can be concerning for pump users • TSA Web site—recommends you notify the security officer you are wearing a pump and ask for full-body pat-down and visual inspection of pump • Advise officer pump cannot be removed as it has needle (catheter) under the skin

30. TSA Screening • Recommend medications in clear plastic bag in carry on luggage • Rules can be different in other countries; consult airline; list of supplies and medications in signed letter from doctor • TSA.com

31. Medical and travel insurance • Insurance for trip cancellation • Insurance for illness during trip • More inclusive coverage from insurance company • Find out about healthcare system in destination—nearest emergency room and pharmacy • Determine how your regular insurance will cover when out of the state/country • American Embassy may be of help

32. Packing medical supplies • Pack more than you need! Bring at least double. • Carry insulin and diabetes supplies with you in your carry-on bag. • Insulin can go through x-ray; never put in check bags • Divide supplies into two different locations • Have a list of prescription #’s and pharmacy phone # or prescriptions “just in case!”

33. Protect your bottles and meters/strips • Hot or cold climate may affect your insulin, blood glucose meter, and strips

34. Special considerations • Extra batteries for meter • Extra meter • Travel, disposable meter • Travel lancets • Control solution • Sharp’s container

35. Special considerations • First Aid kit with over the counter medications • Antibiotic for traveler’s diarrhea • Water bottle Visit Port #1 Supply Island & Port #4 Disaster Dunes

36. Feet Don’t Fail Me Now!! • More walking on vacation is inevitable! • Diabetic socks or good walking socks • Never bring your new shoes on vacation • Protect your feet • Be prepared for problems • Check your feet daily! • Seek care promptly

37. Moleskin products for blisters and calluses Visit Port #2 Tootsieville

38. Eating on vacation • Enjoy the change of pace—no cooking, different restaurants, different foods. • Learn about local cuisine and specialty items before you go. • Ask how foods are prepared so you can make better choices

39. Don’t drink alcohol on an empty stomach • Avoid drinks with sugar based mixers • Bring handy nutritious food items for in between snacking or when no time to stop or the travel day

40. Don’t skip meals and keep portions controlled. • Take time for more activity to balance out eating and extra calories. • Drink plenty of water especially in the summer heat and when more active. Visit Port #3 Nutrition Junction

41. Don’t go too low • Hypoglycemia can ruin your day. • Hypoglycemia is dangerous. • Hypoglycemia can occur when you least expect it. • Hypoglycemia can occur when there is a change from your usual eating and activity. • Check BS before driving.

42. Hypoglycemia • Be prepared with healthy, portable snacks to prevent hypoglycemia • Be prepared with treatment options if needed • Don’t forget the Glucagon Emergency Kit if you have a prescription Visit Port #4 Disaster Dunes

43. Dealing with travel tension • Stress (and excitement) can trigger hormone release which can raise blood glucose • Manage your response to stress • The 4-7-8 Breath • Inhale through nose for count of 4 • Hold for count of 7 • Exhale through mouth for count of 8

44. General Traveling Tips • Prevent blood clots and swelling— • walking about every 2-3 hours • leg exercises while sitting • Traveling East will shorten your day and decrease insulin needs. • Traveling West lengthens the day and increases overall insulin needs. • In extreme heat, insulin in absorbed more quickly; be prepared to adjust doses

45. General Traveling Tips • Check blood glucose every few hours, especially on travel days, until you settle into a routine. • Drink lots of water while in flight and while away. This helps prevent clots, jet lag and constipation. • Sun protection! • If you don’t give time to diabetes, diabetes willtake time. • Be resourceful.

46. Proper preparation and prior planning prove to prevent problems! 7 P’s

47. Bon Voyage!