We all learned at diagnosis that whether it be errands or an expedition, your child's T1D will be going with you. The quick outing entails a mad search for the test kit and packing insulin, glucagon, and a fast-acting carb, while a family vacation requires at least triple the planning and double the baggage. But even though it can be challenging and even scary, there is something to be said for making the effort to travel. In a larger context, our kids need to know that nothing should stop them. And although their lives are complicated by their condition, having T1D is certainly not an excuse to accept a mediocre life.
Out & About
Essentials
Before having children I preferred to carry a small purse. There was no room for clutter: just the essentials to get from Point A to Point B. Then our daughter came along and a diaper bag became my constant companion when I ventured out of the house. And then diabetes came along. My daily tote more closely resembled luggage than a shoulder bag. Mary Poppins would have been proud. It carried the contents of the diaper bag and was replete with medical paraphernalia and snacks.
I was able to scale down to a large purse now that diapers are no longer needed. In order to feel comfortable leaving the house, I must carry the following: blood glucose meter, test strips, lancing device, lancets, syringes, insulin, glucagon, 45 different snacks, glucose gel, a urine ketone strip, wallet, cell phone, keys and, finally, the endocrinologist's pager number.
For a day-trip away from home, I double everything above and add a complete set of site change supplies for the pump, a blood ketone meter with test strips, and the pediatrician's pager number.
For an extended trip, I take the same as above, except for the diabetes management supplies, like insulin and test strips. For those items I calculate how many our son would need for the length of the trip, and then I double that number and round up to an increment of 50.
Example: We are taking a 5-day trip and will test blood sugar an estimated 12 times per day.
Result: We will need 12 test strips a day x 5 days x 2 = 120. Then rounding up would be 150 test strips.
(It's hard to imagine, but I can recall one trip where we used this formula and ran out of strips for the flight home. I had to phone the endocrinologist for an emergency scrip to buy test strips at a pharmacy near the airport.)
When it is time to pack, we gather up all of the supplies and snacks and break them into two equally-equipped carry-on bags and one cooler. Remember to never check your child's diabetes supplies. Those supplies must stay with your family at all times. Travel can be fraught with unexpected delays, lost luggage, and theft.
Although this method has worked for us, it may not be either practical or adequate for every family. This is simply our strategy when going out and about. Your diabetes team should have instructed you on the bare necessities when leaving the house. Also, if your family has some tips for running errands or travelling with the essentials, please contribute on the Share page. We would love to have some more input.
Quick tip: To keep insulin at a cool, constant temperature, look into Frio® wallets. They're great for hot days.
Hotels
When our son was still in diapers, I would not even consider staying in a hotel room without a kitchen. Now that he's a little older and not quite as picky an eater, our prerequisites are a mini-fridge and an indoor pool. All hotel mini-fridges, though, are not created equally and do require vigilance. It is a distinct possibility that you can either cook or freeze the insulin because of a tempermental thermostat. We have had some scares with temperature control in the past, so I just made it a rule that when we check blood sugar, we check the insulin's temperature, too. Even if the worst happens and you need a new vial of insulin, your doctor or the on-call physician can help. They should be willing to phone in a scrip to the nearest pharmacy at a moment's notice. If you need insulin in the middle of the night and there aren't any pharmacies open, hospitals are open 24 hours a day.
Quick tip: Be sure to lock up your child's syringes in a hotel safe when you are away from the room.
Air Travel
Our family has flown through several airports all over the country during the last two years. Every TSA experience was different, even when going through the same airport.The agents may or may not let you stand with your child during a screening. The walk-through screening may or may not trigger an alarm because of an insulin pump. (For our son, the alarm goes off almost every time.)
The security screening has easily become my least favorite part of air travel. I think I'm at my most disgusted when my toddler is forced to stand in a star-shape to be "wanded" and then watch as a security agent frisks him simply because he's wearing an insulin pump. A close second occurs when security personnel dig into our son's diabetes-related supplies only to put them all back in a different order. I always worry something fell on the floor and was missed in the furious re-packing. And be prepared for the agents to swab every single snack in your cooler. Believe it or not, it once took an extra 15 minutes to get through security because the agent decided to swab all the toys in both our kids' backpacks.
When approaching security, warn them you are carrying diabetes-related supplies. And if you are not happy with how you or your family members are being treated, ask for a supervisor immediately. Show the supervisor a letter from your doctor stating that all of the supplies and snacks are medically necessary. In addition, it is good idea to have on hand the TSA policies (link below) regarding travelling with a medical condition.
Lastly, be sure you check with the meter, pump, and CGM manufacturers about their recommendations regarding air travel. Some equipment may malfunction or not tolerate the x-ray machines during the screening process.
Helpful links:
Conferences & Camps
Diabetes conferences present wonderful opportunities to meet other families, become up-to-date on research, further diabetes education, and see first-hand the latest developments in diabetes management technology. These gatherings are terrific for educating and empowering the children and their loved ones. The Children with Diabetes conferences, in particular, make a special point of addressing the emotional and educational needs of siblings and grandparents.
Diabetes camps can be for the T1D child or the entire family. It is a comfort to many children who attend these camps to be among those who truly understand how they feel. Camp counselors are typically volunteer physicians and nurses. The lessons taught at these camps usually include having a healthy attitude regarding T1D and how to most effectively manage diabetes for the rest of their lives. For many of these kids who go solo to camp, it presents an opportunity to feel a sense of independence not experienced very often at home.
The following links are a sample of what is available to those coping with T1D.
Sleepovers
I am dreading the day my son comes to me and asks to sleep over at a friend's house. A veteran T1D parent said once she thought sleepovers were weird and no one needs to sleep at anybody's house. I get a chuckle from her saying that, but we all want our kids to have the same experiences as other children their age. How in the world do T1D children safely sleep away from their parents? I would love some input from other parents on this subject. Please contribute on the Share page.
Until we have some first-hand experiences to mention, these are a few of the suggestions I have heard or read about:
- Train the other, very trusted, parents to do the injections, blood checks and count carbs. They are to call you for corrections, bolus, and basal amounts.
- Have the child inject/bolus himself and check blood sugar every two hours. He should phone home if out of range.
- Drive over to the sleepover location and do checks and injections yourself.
- All sleepovers should be at your house.
Babysitting
Most of us have very few people to rely on to watch our T1D child. For my husband and I to go out to dinner alone takes quite a bit of planning. There are a total of two people we can leave my son with for any amount of time. Attending a diabetes support group is helpful for so many reasons, not the least of which is emergency babysitting options.
There is also an organization called SafeSittings.com that connects T1D teens with parents of T1D little ones. You may get lucky and have a babysitter available in your area.
