Month

April 2017

Flying with an Insulin Pump: What Your Doctor Forgot to Tell You

Having an insulin pump has been a life-saver for me. It really has.  But flying within it has been an absolute nightmare that I had little warning about. Hopefully my experiences can help others have a more pleasant experience. And though I use an Omnipod, which has no tubing, this may also help others using a tubed insulin pump.

I fly probably 6-12 times/year. I’m actually flying as I write this. My blood sugar is also 50 at the moment. I’m eating maybe my 6th glucose tab, and I have already had at the least 60g of carbohydrate before eating these glucose tabs. I’ll admit I’m about on the verge of an anxiety attack and focusing on writing this is keeping me a little more calm. Oh and my ESA dog on my lap.

flying
Tucker looks out the window while I down some more glucose tabs.

 

Anywho, if that doesn’t tell you what a mess my blood sugar is, I don’t know what will.  I was 153 when we took off.  No insulin on board. I bought a snack pack with 42g carb at the airport, and ate the applesauce before we took off, and the crackers/meat/cheese after we were in the air, without any insulin.  Mostly because my Dexcom was resetting so I couldn’t see my blood sugar and knew sometimes I go low on flights.  I figured worst case, I’ll just take insulin if I go high.

The stewardess came around and gave us honey peanuts and Wheat Thins.  I ate those too.  Hey, I hadn’t eaten all day in my last-minute-getting-ready frenzy! And that did not attribute to the lows because I frequently skip meals with no issues. FYI.

Now my Dexcom just says LOW. WTF. Ugh. Turn around Dex, turn around!!!! I’m absolutely positive I’ll go really high after this. And I’m not talking about the airplane altitude.  Hardy har har.

I’ve had this issue before.  I have a normal or even high blood sugar as the flight starts, and mid flight I’m clammy, eating all my snacks, and asking the stewardess for more.  For absolutely no reason.  It took a few times before I finally decided to Google the issue.

The Low Down on Flying With a Pump

Apparently with insulin pumps, the change in pressure in the cabin of the aircraft can push extra insulin out of your tubing due to any air bubbles.  I know, and Omnipod has no tubing, but it can still push out extra insulin from any tiny air bubble in the device (obviously, it’s doing it to me). From my research, Omnipodders have commented on the discussion threads saying they don’t have this issue as often, but I am one of the lucky bunch.  And apparently if you are using a tubed insulin pump, you’re even more likely to be lucky.  BUT if you have a tubed pump, it is way easier to avoid the issues.

For anyone flying with diabetes, PACK EXTRA SNACKS. Pack all the snacks.  All of them.  As a chronic over packer, I hate packing things I deem unnecessary (like a bunch of food) but THESE ARE NECESSARY. Glucose tabs and your favorite candy bar. Seriously, this is your chance to possibly consume, take it.

So for the easy part, if you have a tubed pump, while flying, disconnect upon ascent and descent. This will for the most part prevent the air bubble issue and your pump should function as normal.

Oh I’m finally 45 and not LOW! Yay! Oh the little victories.

With an Omnipod, this is much much more tricky. You literally have to take your pod off to disconnect.  Doing that twice is tedious and nor practical. So what can you do? Once you board the plane, suspend your delivery. Even if it’s 30 minutes until you leave, suspend.  Then wait until you’re about 30 minutes in the air to resume. That’s about an hour without insulin delivery, but it should compensate for the extra insulin. Granted, I am not your doctor and these are SUGGESTIONS only, but this is what has worked when I’ve done it.  I just thought my carb consumption would make up for it today. Clearly not. But it will be way easier to correct a potential high than deal with a potential low (in my mind). Also, if your blood sugar is relatively high ahead of time, you may not need to.  It’s a learning game and it’s pretty much never the same to be honest.  But awareness is key.

Oh! 77! We are on the upwards (and likely seeing something super high way too soon).

So once I started noticing the issue and Googled it, I asked my doctor, who also was the person that came to my home and trained me on my pump.  She had no clue. Had never heard of the issue. REALLY? Blew my mind. How could I be the only person with this issue? But like I said, I’m super lucky, sooooooo.

And now the rise alert from my Dexcom, because I’m rising faster than I should be, and the plane is about 15 minutes from landing. Looks like I’m about to ride the diabetes rollercoaster that is my life. Luckily I have some Afrezza with me to hopefully blunt the rise/precent me from going too high. I’m going to need a nap after this and it’s not because I had a drink on the flight…

Update: I started to rise but then dropped almost low (see Dexcom photo), likely from the descent. Of course expecting to drop further, had some juice and then spiked. Flying home I am going to turn off my Omnipod and see what happens!

flying

Tonsillectomy: What You Can Learn From Mine to Survive Yours

Word to the wise, if a doctor even hints that your child may need a tonsillectomy, just do it then and there. The sooner, the better. If you love your child even just the smallest amount, you will do it.
It’s pretty well-known that an adult tonsillectomy is way more painful than when children have the surgery. A doctor told me in high school I’d eventually need my tonsils taken out. Why didn’t he take them then?? So I learned the painful way how to handle the 2-3 weeks of pain following a tonsillectomy.

Long (like, really long) story short, I was talking to a friend about how terrible I sleep, and how hard it is for me to catch my breath when working out, and she suggested I go to an ENT (ear, nose, throat) doctor.  She had the same issues and had a deviated septum, that once fixed, solved everything.

At the appointment, I was blown away by how many of the symptoms they asked about I checked off the list. Sleepy? Cranky? Irritable? Hard to focus? It goes on and on, and some of those may be character traits, but regardless, things started to make sense right there.  They then stuck a really uncomfortable probe up my nose to look in my throat. Results? My adenoids and tonsils were huge. Kinda knew that.  Also, adults shouldn’t really have adenoids anymore so the fact that mine were huge….Anyways, he said we had to do a sleep test for insurance purposes to see if it was affecting my sleep. Huge eye roll from me on that one because, duh, it’s affecting my sleep, that’s why I’m so cranky all the time! Or maybe that’s just me.

I did the stupid at home sleep test and definitely slept like crap.  Seriously, who is able to get a normal night’s sleep with all this gear on?

tonsillectomy

 

Follow up appointment, I have slight sleep apnea, because my tonsils and adenoids are blocking my airway. Time to yank ’em out. I strategically scheduled my surgery after my birthday and when my mom could come take care of me.  I honestly probably would have thought I could go without my mom if I didn’t have diabetes. I just wanted her to watch my blood sugars while I was in surgery. This was a bad assumption. You need your mom. Or your dad. Or a significant other. No matter what. There is no circumstance in which you should attempt this alone at all. Just a ride home from the hospital from a roommate is not enough.

The day before surgery my mom arrived and we had a last meal at Olive Garden.  I never ever eat there because it is WAY too many carbs, but I knew I wasn’t going to be eating for a while so went all out and ate every last carb I could find. I won’t go into detail on how bad that screwed with my stomach. But it was delicious and that’s all that matters.

Surgery day I barely remember.  I don’t even remember falling asleep on the table.  I slightly remember waking up and someone giving me a pain pill (highlight of the day?) and then my mom giving me some vitamin water and trying to get me to drink it at home. When I finally came to that evening, I didn’t feel right. I felt like puking, I couldn’t breathe, I couldn’t swallow…I’m pretty sure I had a full on anxiety attack. Thinking back, I may have just panicked.

Anyways, my mom took me to the ER, where I was finally admitted at like, 4 am. After the surgery, the doctor had put a local anesthetic on the back of my throat that lasted 3 days, and somehow it was making me produce a lot of mucus I was unable to swallow. So I spit. For three days.

I spent those three days in the hospital and I can’t exactly tell you what I did for three days.  I watched one movie, but not really any TV. I didn’t read or text.  I just, stared at the wall.  And spit.  I hardly slept either because I very rarely was allowed any pain medicine or anti-inflammatory. It really varied depending on the nurse. So when I had that relief for a few hours I slept a little, but that’s about it. I also didn’t eat. At all. I couldn’t swallow so I didn’t eat. And I wasn’t hungry. For three days.  What the what? I can usually only go three minutes without being hungry!

tonsillectomy
At the hospital, I somehow got a picture of my wonderful accommodations.

And on the third day…I went home. Finally. And miraculously I stopped needing to spit. My mom mixed some Percoset with some vitamin water and I was set. FINALLY some pain relief and a nap! She also changed her flight to stay a week instead of the three days she was originally going to stay.  Thank the Lord, because I definitely needed it.

Here’s what the doctor failed to mention:

  1. You are literally OUT for two weeks.  At the minimum.  It’s not two weeks of pain, it’s two weeks of doing nothing.  I couldn’t even concentrate to work from home.
  2. Set an alarm for every 4 hours to take pain meds. If you don’t, you will wake up feeling like death for an hour, and have to ice your face while you wait for the pain meds to kick in again.  And that’s if you can swallow them.
  3. The swelling is what causes the most pain/discomfort.  When I left the hospital they gave me an anti-inflammatory to take for five days, but only five because it can cause liver issues.  Let me tell you, I rationed that like no other. It was better than the pain meds and helped me to sleep.
  4. Even protein shakes hurt going down. You can literally only have things with absolutely no texture.  Popsicles are clutch.
  5. When you do start eating solids, and by solids I mean mashed potatoes, it will take at least 30 minutes to eat half a cup.  You are going to have to learn to eat again.
  6. Your blood sugars will be the best you’ve ever seen them, because you aren’t eating!
  7. Forget talking. You’ll maybe whisper for 2 weeks. Then have half a voice for the next two.
  8. And don’t even try to whisper close to someone’s face.  Your breath will be bad. Really bad. Like my mom wanted to call my doctor because she thought something was wrong bad.
  9. Once you can eat something solid again, DO NOT BINGE. DO NOT EAT JUNK FOOD. DO NOT GO CRAZY. Because your body has not had this crap for so long, it can’t handle it.  Guess who threw up chicken wings and fries her first night eating solid food??? (But seriously, tell me you wouldn’t be craving these wings either).

I’m pretty sure I blacked out the three weeks after my tonsillectomy. I really remember very little.  My mom somehow moved me into a new home. I definitely could not have survived without her.

Was it worth it? Definitely.

According to my Pillow app on my Apple Watch, my sleep quality has drastically improved.  Also, I can work out!  Granted, it’s been slow getting back into it after first breaking my wrist and then having the surgery soon after that healed. But I can feel it when I run or get my heart rate up.  Air can actually flow through my nose and into my lungs.  It’s almost liberating. If you need a tonsillectomy, you should get it done, but really be ready. I thought I had a high pain tolerance, but definitely fell to the mercy of tonsillectomy pain. Again, the younger the surgery, the less painful the recovery (at least with a tonsillectomy) so if there’s even a remote possibility tonsils are affecting your child, just get them taken out and save them the pain later.