October 15, 2021 Travelling (Again) with Diabetes

welcome everyone uh my name is brooks

roach i'm a diabetes education

specialist with diabetes canada

and i'd like to welcome all here today

and start by acknowledging that i am

joining this webinar from the

traditional and unseated territory of

the migma people

prince edward island and wherever you're

joining or watching from i invite you to

express gratitude and recognize the land

on which we live

and the past inhabitants of these

indigenous lands we now call canada

so i am here joined by a couple of

wonderful guests today to talk about

something that may feel a little bit

unfamiliar after the past roughly 18

months and that is travel

so it's likely been a while for you and

we wanted to take this chance to offer a

reminder or introduction to the best

strategies for managing diabetes well on

the road in the air and all places in

between so we're joined today by chris

jarvis who is an olympic grower and

founder of i challenge diabetes

christian type 1 diabetes welcome chris

and amanda gill who also lives with type

1 diabetes and is a destination expert

with kensington tours

and has tracked nearly 60 countries so

welcome and thanks thank you to you both

uh really excited to hear what you have

to say on this topic

we'll be covering some key topics around

travel and we'll also be taking

questions from you our viewers so if at

any point through the the webinar you

have a question or comment feel free to

post it in the facebook comments and we

will pose it to our guests

some questions have already been

submitted and uh feel free to to keep

engaged

so we're going to go ahead and get

started with amanda

and the question i want to quote to you

amanda is what are the key differences

that people with diabetes will notice

when they're traveling now compared to

before covet 19.

hi thanks brett brooks

so i mean i think the first thing to

acknowledge is that

travel can be stressful at the best of

times um but certainly with

added measures for coved it can be more

stressful um so be mindful of that that

you you know may end up with you know

extra stress spikes to your blood sugar

for

no apparent reason

um but one of my biggest pieces of

advice is to be prepared there's going

to be longer lines are potentially

either and

you know things like less service on

flights so be prepared with you know

extra low supplies and snacks um i've

experienced in pearson airport the water

fountains have been blocked off

um so i normally bring an empty reusable

bottle to then fill up when i go through

that's not a as easy to do anymore

um you're gonna be need to be wearing a

mask throughout your flight uh with the

exception of eating and drinking

um

wearing a mask is always a challenge

we're all used to it now

um but one thing i've done on flights is

i actually bring a straw that way when i

am thirsty i don't need to remove my

mask and i can just slide the straw

under my mask to have it have a drink

um

as well on shorter flights and you know

instead of having a meal on the plane

and having to remove my mask for that

uh i might eat beforehand and on a

longer flight if you're going

internationally um you might get hungry

in eight or ten hours

so just

you know kind of understanding and being

comfortable with taking off your mask

for those meals and before putting it um

before putting it back on

um i have found on domestic flights that

there is less service um being offered

um

smaller meal selections

uh

so again maybe you're bringing your own

snacks uh which you may already be doing

but uh just be prepared that you may not

have you know you may only be able to

have that

tin of pringles by the time they get to

your your seat uh trust me that happened

to me this summer that that was all they

had when when the the meal cart reached

my aisle

so those are um

you know a few little tips for the

flights

um and then as well if you're traveling

internationally you may have

requirements for taking pcr tests

beforehand

showing those results showing

vaccination certificates

so again being prepared for those longer

lines making sure you've got your low

supplies with you

because you may not be able to run to a

kiosk to buy to buy a juice um if

something happens

hey yeah thank you amanda i personally i

haven't been on a plane since early

early 2020 so um

the the resounding tip that i keep

hearing is making sure that you have for

example any proof of vaccination any you

know vaccine passport any um basically

just stocking up on whatever new forms

of paperwork that have appeared in the

last couple of years as well as taking a

bit of extra time to stock up on on low

supplies is that the pro tip

um

so the next question is going to be go

to chris and this is sort of looking at

travel a bit more in general outside of

the scope of what has the pandemic done

and that question would be

if i have travel on the horizon if i'm

planning a trip what are the key steps

that i should take in the planning phase

thanks brooks and uh definitely when i

was younger um

i didn't do much travel with my family

we were very like locally based and so

it's actually my my sport that drew me

out of it and i think that's a wonderful

thing for all of you that are watching

this webinar today you've already

realized that you could learn from your

teammates and diabetes canada is putting

on this webinar here to help share some

insights so please feel free to ask

questions um i think i was so

accelerated in my learning because of my

teammates around me

now one of the things that they didn't

have is all of my rowing teammates which

was the the main thing that i was doing

on the national rowing team

as they didn't have diabetes and so

there were some of those things that i

had to learn the hard way and so you

know we first off think about our

supplies that we might need for day to

day and then if you think about the

things you might want to do on that

travel horizon that's going to help you

to start to zoom in on that so you can

be prepared for it so we have learned

that there's lots of other um

types of gear that comes along with

those sports or activities that you

might want to do

so a dry bag for example is something

that you can roll up and keep your

supplies safe from water if you could

believe it i went rowing

for um 18 practices a week until i got

to the olympic level and i'd never heard

of or seen a dry bag and then i went on

a white water rafting trip and other

people had dry bags for their

electronics and i didn't have that for

my diabetes gear

so that was something that i really

encourage you to do is not only to think

about what you need but think about what

other people are doing in that

environment and how could you adapt that

to be your diabetes support i mean a big

thing for me has been traveling is the

diet in that local area and that could

be some brand new foods that you might

be expecting for me living with celiac

it kind of puts a little extra pressure

on it but to start calculating and

thinking okay so there's a rice based

diet i'm gonna have to get really good

with that and get a little bit prepared

so it's not bringing any extra anxiety

and you can deal with it in advance um i

remember even just in being in the south

of uh the united states some of the

portion sizes down there were

monstrous and

i was pretty excited about it to be

honest but it definitely meant that i

needed to be calculating a different

amount of insulin and a different amount

of activity to balance that all out

or bring some to-go containers if

nothing else lastly i would just

encourage you to think about the

language that you need to be uh thinking

about and if you're going for an

extended trip or a trip to a remote

place somewhere that you wouldn't be

able to access the type of medical

supplies that you're bringing you might

want to think about the the language

that you're gonna need to have and have

a little note card or an app that you

can help with in case you were to lose

your insulin um you know heaven forbid

but we have heard that over and over

again that it's one of the biggest

challenges that someone has their

diabetes supplies um put aside and then

they lose it somewhere

so being able to know where you would

find that what kind of support could you

get in that country and what kind of

language are they speaking there those

are good things and that's what i

learned from my teammates they would uh

you know jot down a lot of the popular

expressions that they wanted to use when

we're going to somewhere

say italy um to to be able to converse

and support yourself as you go touring

around

thank you chris um i i think there's an

interesting uh

point in there about these longer haul

treks which amanda you had mentioned

that earlier about some of these you

know if you're preparing for an eight to

ten hour flight or or longer um the

difference in preparation that you have

to inject into that so i'm wondering

about if you could share any advice for

adjusting insulin specifically when

someone is traveling across multiple

multiple time zones

yes certainly um you know obviously

my first recommendation is talk to your

medical team because they may have

different advice um but i've certainly

over many years of traveling with

diabetes have honed things and

differently than i did when i was on

multiple daily injections um i'm now

i've been on an insulin pump for over 10

years and

and so

my methods have changed um

with my pump i am using an older model

um medtronic pump and um

i tend to

adjust the time on my pump

as i'm in flight so for example if i'm

flying from toronto to vancouver

it's a three hour time difference

flight is about four and a half hours

but let's say six hours you know from

arriving at the airport until leaving

the next

so i'll adjust the time on my pump every

two hours by one hour

and so on you know flying to

[Music]

nepal or something you know i've got a

bigger time difference a longer journey

so i kind of balance out how long i'm in

transit and that does seem to work for

me

um but one thing i do find is very often

in flight you might

run a little bit higher

um just due to inactivity i'm certainly

i know i eat more when i'm in an

aircraft than i do normally because they

often just keep bringing more snacks and

meals

so i'll often

increase the basal and level of insulin

i'm getting you know whether it's 10 15

percent to try and keep myself in range

and um

but then

towards the end of my flight um i do

find as as i land my blood sugar may

start dropping especially when as we've

all experienced at many airports around

the world you could be walking 20

minutes just to get to customs or to the

baggage carousel

so i'm always prepared that i may have

that that low on arrival and you know

again going back to talking before about

being prepared with your

low treatments i can't tell you how many

times i've munched on glucose tablets as

i'm waiting to uh

speak with the customs agent

uh so those are some of um some of the

tips that i um personally

take when i take with me when i'm

traveling but i know chris you

so use some different methods and do you

have uh

any different suggestions

well i think um what's a little bit

relieving here is that we have a little

bit more stability in both the long

acting insulins that some of you might

be using as well as with insulin pumps

that are automated at this point um and

so there's a couple of different brands

now and i use one of them that will

actually adjust my background insulin or

my basal insulin

as as is needed and so that's kind of

relieved a lot of the the tension around

when do you actually change your time

zone and how much of that time zone will

play a factor because all of your

activity as amanda was saying when you

get off the flight i've definitely had

that uh you know off the flight low

happen too many times um so that's part

of my plan as well and i love the uh the

recommendation to talk to your your team

and come up with a plan to share with

them i think that's really helpful but

uh yeah the automation of pumps and the

stability of the long-acting insulin is

really helping us uh to have confidence

when we're traveling

yeah absolutely um you know i can speak

myself i remember a pretty catastrophic

low landing in brisbane after a you know

14 hour flight vancouver to brisbane

australia and uh that's that prime

example of a lot of inactivity then even

a slight change of just wandering around

the airport the mad scramble to get

luggage that led to a pretty significant

crash so it's definitely a recurring

theme

um

i'm thinking on that note of

actually managing medications and

technologies

i'm wondering chris if you could share

some best practices on actually

going through security and screening and

managing a person's medications and

technologies in that setting

thanks and

um

i think that the idea of managing is is

the most important thing

this is one of the areas that can cause

the most stress i think for people when

you're going through security and

screenings um i've even had you know go

going through security but then just as

you're getting on the plane another

surprise security uh screening there um

so on that note i think it's most

important for us all to try and find

that inner calm because there are times

where you're gonna run into the wrong

person who might be maybe we could use

the word ignorant more aggressive or

hostile and as long as we maintain our

cool and you explain that this is

medical equipment um that person will

have to go and check in with someone

else and you'll find somebody who's much

easier to talk to about that so i've had

that happen before where i got a little

hot tempered and brooks i think that's

the biggest learning that i had along

the way is that my response to that

didn't help at all

um so i've been through the check stops

at airports hundreds of times and i find

that every time that i bring it and if

it's nicely organized then it's even

easier so you know finding an

organizational system where you know

where your supplies are

and what you brought with you

and i've actually discovered this by

accident that when you

reveal like that you have a medical

condition it can actually help so i had

a juice box which i wasn't intending to

fly because at that time you know flying

with liquids was

definitely not approved and so um i

mentioned oh shoot you know that that

was for my low blood sugar and the

person said oh do you have diabetes

and that was just a really nice uh agent

there that was doing the check and they

said oh well you're allowed to have

something to treat your low blood sugar

and i'd never known that that was

actually permitted so i was always using

dex tabs or some type of solid

low treatment so i try to pass that on

as well is that we are allowed to have a

reasonable amount of low

supplies in most circumstances but i

would always bring um you know something

that's that's hard uh as a backup as

well there but i think the attitude is

the biggest thing that helps us to get

through that and then knowing where our

supplies are

from uh you know a fear perspective i've

had people that um would put their bags

in check luggage and goes under the

plane i think that's one thing that we

want to watch out specifically with our

medications because the plain

temperature where the luggage is is not

regulated so that uh that could cause

some freezing of insulin or other

medications that we wouldn't want to see

but it is nice to have backup supplies

there so if you're going on a long trip

for example you might want to have some

backup you know needles or pump supplies

anything like that um but your actual

liquid insulin supply should be with you

on your carry-on um and i also say that

you know when you put it up above your

head in the in the stowaway you also

want to make sure you have something

right there with you at the seat because

it could be you know a time where you're

not allowed to get up there's turbulence

and that might be a time where it's

really ideal to do maybe an injection of

insulin or maybe a pump site has fallen

off or you have a low blood sugar so i

always have a smaller component

component that can pull out and come

right into the seat with me and a lot of

people say you know oh chris you're six

foot four how do you fit into one of

those airplane seats um

you figure it out right you just find

your way to be comfortable and the same

thing with a long travel um in a car

right you wanna have the same supplies

with you accessible and you never wanna

say oh you know i'll be fine

why not have those supplies ready and so

i do the same thing i've driven across

canada back and forth i've driven down

to florida uh driving a 14 person

passenger van with one of our charitable

initiatives

and so always being ready if you don't

have a sensor um you know making sure

that you're testing in frequency uh

frequently and managing that so it's

always accessible when you need it

that's what i would say

thanks chris i think that's a super

helpful um

the idea of what person's attitude or

mindset dictating so much of the outcome

is super super relevant i think

oftentimes planning a trip

it becomes so overwhelming because there

are so many factors seemingly beyond our

control that if you can kind of zoom

back in and say well there are that's

going to be the case but if so long as i

am aware of what i need what i have on

me

i'm going to that will set me up as well

as i possibly can

and that's the same sort of approach

being applied to having

the right supplies with you even even in

the right space within the plane uh

you're planning it as much as you

possibly can recognizing there is

potential for you know plans to go awry

but you're building sort of an antibody

to that

and i would say as well um i didn't

mention about like if you are someone

who wears an insulin pump uh going

through the the sensor uh going through

this you know the new scanning device

that stands your body for metal um the

ones that actually move and have the

magnetic rotation um you don't have to

go through that you can ask for someone

to do a pat down

and you can also wear your insulin pump

through the

the one that beeps when you when you

walk through it um and that one uh you

can let them know that you're wearing an

insulin pump

i find that um

you know it's really again it's the

person that you're dealing with if you

walk through and you keep it hidden in

discrete

sometimes the pump does not go off it's

kind of like a cumulative effect of

metal um so when you walk through there

uh if you do have a beep like let them

know what you're what you're holding and

why

and most people respond really well and

again on that note of your attitude it

kind of dictates the way you can't

escalate the

the

the fire here if you're staying calm and

telling them that you have diabetes this

is an approved device and uh and you'd

like to speak to somebody who

understands right

so

yeah totally i think we might have a bit

of a a cat trying to get in on the

action but

yeah

aggressive just like some uh

of the agents that i've dealt with in

security

um

so i i really appreciate the the wealth

of travel experience that you're both

bringing into this uh in in very

different capacities headed very

different destinations and i just wanted

to kind of open the door if you if

either of you had anything else any

other points or tips that you wanted to

share um to feel free

well i think um you know cr chris was

talking previously about you know not

putting insulin um in the undercarriage

of the aircraft

and on a similar note i do find

especially on longer trips

it's good to sort of separate your

supplies but between a few of your bags

um because you never know when you might

leave that backpack sitting on a bench

somewhere or

you know the um trust me i once had a

trunk get locked and we couldn't get our

baggage out of it they had to take apart

the car

um

and so you know it was good that i also

had pump supplies in my backpack in the

car with me while we waited several

hours so i could get the rest of my

supplies

relieved so that certainly

never keep everything in one place

because whether you leave it behind or

heaven forbid something gets stolen

you'll have a backup

and i think amanda the uh the one saying

that someone said to me when i was much

younger is a place for everything and

everything in its place

and for those of you that that hate

organizing things i'm not the type of

person that likes to take that time and

have have had struggles for that reason

but the more that i commit to that

especially while traveling and thinking

about the motivation of it right i am so

excited to be traveling i'm really uh

you know hopeful to have a good

experience here if you can use that to

motivate you to put things back where

you expect them to be and then that way

every time you need that blood test kit

or or the the piece then it's not an

added stress and diabetes you know can

pop up us on us

in the worst of moments

um in fact when i was traveling this is

prior to covet but i was traveling with

my two daughters for the first time um

juliet was still a little baby in the

car seat and then stella was just old

enough to walk and i had a low while i

was trying to carry the car seat and

holding stella's hand walking through

trying to meet up with my wife um

and it was

it was definitely something that that

caught me off guard and had me a little

stressed but you have a plan and so you

go back to your supplies you know you

you grab onto those um and then we can

get through a lot of these challenging

moments with a little bit of impact into

our big trip travel and that's what i

like to look at is if i have to pause

for 15 minutes to fix this it's within

my plan

and you know i'm going to be able to

deal with it and and that helps me to

stay calm head and not make any further

mistakes

so that's uh

that's that's what i would hope for is

to be able to remember where i put my my

supplies doesn't always happen to be

honest but i do try

thanks folks um so we're going to open

the floor two questions we do have a

quite a number of questions coming in on

on facebook so want to make sure we have

have adequate time to

to meaningfully and properly answer

everyone um the first one is regarding

hydration on flight so uh it's the

question group says water on flights uh

guessing that they do not give much with

less staff based on what you said

earlier

um so recommendations for getting enough

water to stay hydrated hydrated i'm

assuming this is especially with with

longer haul flights

yeah and uh so as far as that goes

because i was mentioning for example

toronto airport

at least the last time i was there in

august i couldn't use their water

fountains however i have found at some

of the restaurants near the gate they're

very happy to fill up my reusable

bottles or of course you can you can

purchase at the kiosks

but i always will have at least 750 ml

of water that i fill up and bring on

board with me when they come around

offering drinks i'll usually ask for a

couple just to to to stay hydrated and

and generally i'm always leaving still

with water in in my bottle

yeah that's a good point because i've

definitely been the person that brings

around my reusable and being caught

unaware uh seeing that the fountains

have been closed off i hadn't thought

about that as an

option

and certainly going on to a plane with

an empty water bottle isn't very helpful

so that's a great question

thanks

the the next question we have is a

little bit to do or a little bit related

to for example chris your point around

being able to have a juice box on hand

and this question is

i've been told that we can take an extra

piece of hand luggage carrying all of

our diabetes supplies on board is this

true

do either of you know know more about

this

well i i don't know the actual

regulations on it um but i do know that

um that i often bring a small

uh component with me as i mentioned and

i try to keep it within the size i think

the size is really where you're gonna

get into trouble so if you're packing

huge bags and an extra one that's when

they're gonna be a bit more critical um

but but amanda i'm not sure if you have

more

understanding of the actual regulations

there

yeah and and it is my understanding that

you can i believe you do need to get

um medical like you know sort of get

approval from the airline beforehand

it's not something i've ever done

because

being allowed you know a carry-on as

well as a personal item like a purse or

a small backpack for

um you know generally i can fit

everything i i need even when i've gone

on month-long trips in those um but it's

certainly if you are concerned about you

know being able to bring a little bit

more on board um contact the airline

before travel um because i'm

i do believe it is permitted if you get

the approval

thanks folks and and we do have uh

diabetes canada does have a web page on

air travel uh and i can look into

updating that if there are any specific

um you know extra extra tidbits

especially post cobit on that front so

uh you can check out diabetes.ca slash

air travel and it will it'll have some

extra info after the fact

um we have a question that says has

anyone had any experience with getting

quote unquote stuck in a foreign country

for an extended amount of time and not

having enough supplies available what

did you do

and a second part to that question is

anyone experiencing issues

charging their insulin pump in a foreign

country due to a different type of

outlet

good

so i have a few experiences being

stuck or you know having an insulin

challenge and so

my first time actually traveling i went

to italy and on the way back because i

didn't speak any italian there were

signs in the airport suggesting that

there was a

closing of the airport at this date and

that was the day after i was traveling

or the day before i was traveling back

so i went to that airport it was closed

and so i had to try and figure out call

the airline company and they'd move my

flight to another city all altogether

um so i ended up spending a couple of

extra days trying to get back home

um

luckily i had the supplies in that case

i think the question is more towards

supplies and so there's two other times

where it wasn't a delay but it was

actually one time i dropped a bottle of

insulin that would have been plenty to

get me through the travel and it broke

and i lost all of that insulin

and so i after that started to be a bit

more prepared about knowing what the

protocol is and how to get

access to insulin um so for example in

the united states what you think would

be the least amount of trouble is one of

the highest uh challenges because you

have to go and see an actual doctor to

get a prescription and pay for that

doctor's experience and then

go back to your pharmacy and i tried to

dialogue with the pharmacist explain

that i just dropped i had the broken

bottle

and they would not sell me a bottle of

insulin regardless so it's good to know

the

policies there and just to be prepared

for it so if you recognize that you're

running low or if you find that you're

going to be staying longer that you're

ready to take action

and the other part there is about the

type of insulin so in thailand for

example i went in just to see

how how that experience was

and getting insulin was very easy but

the type of insulin was very different i

knew that because i had kind of done the

research there but i was curious about

it um and so the type of insulin is is

more of an older style the toronto

type of fast acting insulin which is

different than the hume log or nova

rapid that we might see here every day

thanks chris um we have a question

that's

somewhat similar and it's regarding

supplies uh with extended travel and

this person is wondering about shipping

supplies to another country they have

been keen to go away for months or two

but aren't clear on how to restock

supplies and aren't sure if they could

bring them all

yeah and i'm pro

i won't have any advice for you as far

as shipping goes because i've i've never

had to do it but i have you know kind of

come up with my own little tips and

tricks so that i can

fit a larger volume of supplies into

less space um

so i i use the uh the libra scanner on

my arm and they come in quite large

boxes um but if you take out the

components that you need to insert it it

takes up half the space

now you're supposed to use the same two

pieces that come in the same box so i

use a sharpie and i say okay i'm putting

a one on the two that came to on each of

them that came together and i'm bringing

putting twos on the other two that came

together and then i just put them in a

ziploc bag as opposed to bringing them

in the boxes

and so that's you know sort of taking

things out of the packaging and test

strips and instead of having 50 in a

tube

i i put 100 into the tube so then you

know just taking up that much less space

it depending on how long you're

traveling if you are traveling for an

extended period i you know certainly

you'll want to find a very reputable um

shipping service to ensure

you receive them

yeah and i have seen some so when i was

going to university i was abroad and i

did have some care packages delivered to

me i think that's a fantastic way to go

um and the main thing is to know about

how long you're in one spot

because if you're on a rotating um

plan where maybe night to night you're

moving from one place to another that

makes it a lot more challenging and

you're going to want to make sure that

your supplies have reached a destination

and you've communicated to them that

there will be an advanced package

arriving so that you don't get there and

feel any stress about when uh that's

gonna arrive

the one time that i had an insulin pump

go down internationally um was was

pretty scary it was actually just before

the world championships for me so i was

really worried about shipping and how

that was going to arrive and i think it

was five or six days before the world

championship started uh and i was having

a bit of a meltdown and i went for a

walk and kind of breathed it all out but

it was really impressive to see that

with less than 24 hours i was able to

get my new insulin pump arrive at the

hotel that i was at

so shipping can be a very effective way

to get that and that came from north

america over to europe and so it was a

considerable distance

but but it's important to know that like

you have to follow those steps and in my

panic

you know the last thing that i wanted to

do was get on onto the phone and and sit

there you know and talk through with

with somebody

but but that was such a helpful um

process to go through and the supports

are there for us so um great idea to

start self-supporting yourself um

and i i think amanda's idea about

consolidating and organizing is a

helpful step as well

yeah a couple of couple of really

actionable ideas there and that there is

another question that came in uh

regarding taking traveling overseas and

taking freestyle

libra sensors that take up a lot of

space and i think that would apply both

those strategies would apply as well to

that other question

um we have someone who asked

said that their sugars usually go higher

with anxiety and stress and it's any

ideas for packing insulin pump equipment

etc

um wondering if sensors keep their

accuracy while flying wondering about

pat down with masks on

um

so i i think there's there's quite a

number of questions kind of balled into

into the one recognizing this person

also says they're flying alone and it's

going to be quite stressful so i think

you know we've we've touched on some

really great strategies for specifically

packing uh equipment and supplies uh i

suppose

any uh any any advice regarding accuracy

of sensors while flying or uh keeping

masks on during uh security pat down

yeah well i would say um just kind of

touch on the the first part regarding

the anxious component is that i at some

points would think oh do i really need

to carry all this stuff

and uh sometimes my travel is actually

backpacking where you're carrying

everything that you have with you um

sometimes over 20 kilometers in a day

and luckily i do a lot of traveling with

other type ones so i've seen them bring

extra sensors

and for the while like i would think

okay if this sensor makes it i'll be

good for the whole the whole hike

but then it falls off right and then

what do i do i i'm i'm a bit more

anxious i don't have the same type of

support that i would want

so if you think about that risk versus

reward then even if you have to carry a

little bit extra or you have to be a

little bit more creative on how you pack

you know that you've got those backups

and so i've started to do that and

actually hasn't made any impact on me um

in a negative way i've just had to get a

little bit more creative on how i pack

um and the same thing is gonna you know

translate into our approach to traveling

and being ready the more thought you put

in advance it should gain your

confidence right and um

thinking about how we can manage and

sorry brooks uh if there's a little bit

of a breakout on that but i did want to

comment on how how we can give ourselves

confidence knowing that we have those

backups and um

i know that's helpful

yeah no absolutely crisp a fine answer

amanda could you maybe speak to uh

having traveled a bit yourself you know

over the past let's say over this summer

uh your experience with keeping a mask

on uh during pat downs or as it was

mentioned earlier not needing to go

through a magnetic uh pat down tube or

for lack of a better word but going

through getting a manual pat down

yeah so um you know it's been a while

since i um i have had the manual pat

down um but one thing i'm actually we

were talking about the machine that sort

of scans around you

um when i've gone through those with my

pump they actually do um then they take

me aside and

they like i remove my i show them my

pump in my hand and they kind of like do

some kind of swab on onto it or my hands

um

but uh as far as i'm wearing the mask um

it's sort of like when we're you know

when we're at the grocery store that um

you know we are still still wearing our

mask um

when they're looking at photos they'll

ask you to just move you know when

they're checking your id like they'll

ask you to lower your um your mask so

they can make sure you're the same

person on your passport

um

but as far as wearing masks throughout

the travel

i mean let's face it it's no fun

especially when you're wearing one for

several hours but not only us as

diabetics but everyone around us as it

is in the same boat we just may have to

take ours you know down a few more times

if we're if we're having to treat a low

blood sugar

thanks annetta um we have a question

that is regarding an extra travel pump

uh so it's the question is thoughts on

getting an extra travel pump how can i

get one and i think i'll i'll add before

before i hand the baton over to chris

and amanda um i think a recurring theme

throughout this conversation is when in

doubt having something on hand extra

even if it may be a bit of hassle to you

know find an innovative way to pack that

in um could be a really effective

security measure especially if you know

that you're prone to some of that uh you

know travel scramble stress and anxiety

i'll just say that travel owners have

been a part of the plan for a long time

and i think all the all the companies uh

provide those for you so

um so the one thing that you want to

make sure you're doing is planning ahead

so that you've got time to go back and

forth a little bit with an email to your

to your

choice that you have there um and then

that pump loaner should be coming to you

for your for your travel no matter what

the company is that's available here in

canada um

i definitely think it's a good idea and

it's such a small lightweight device to

like tuck away inside of all the other

pieces that you have

yeah and and to add to that i i will say

make sure you either pre-program that

loaner pump or have your pump settings

recorded somewhere

um

because it's great if you've got a

loaner pump but if you don't know how

much insulin you're supposed to be

getting at different times of day

um

then

it's not going to be of great help to

you

i also always have um long-acting

insulin with me

and uh with a you know with my my

medical team you know i know if i was

without a pump like sometimes i have

gone on very last-minute trips that i

you know didn't have time to get a

loaner um so i at least know that if my

pump decides to stop working i know how

much level mirror orland has to take uh

during that time

yeah that's super helpful tip amanda

having uh something even on your phone

if you have i could keep a note it's

often they're stored on a cloud so you

could access it from any device uh just

just take a quick log of before you take

off on your trip what your basal rate to

what your bolus ratios are to be a a

game changer if you find yourself in

that position

um we have a question

one of the thought there is that

sometimes people will use like an older

pump that they have from a maybe even a

different company and so one thing that

that's going to do is you're going to

have like different supplies for each

pump so i think it's really worthwhile

to ask for the loaner pump from like

your most recent uh

choice so you don't have to bring a

whole bunch of let's say animus supplies

you've got an old animus kicking around

um you know when you've you could access

a loan or pump from from your current

company same thing with a blood test kit

if you bring a backup blood test kit

it's not that you really want to focus

all your business on one product but i

mean it makes it a lot more efficient um

for you to have the same strips as

backups um i have seen people on our

trips that will bring like one tube of

of backup supplies uh with a backup

meter that's different and then if that

one meter goes down and then they're

they only have 50 test strips for their

backup right so that's not very many so

it's good to use the same brand i just

thought might be a useful tip as well

yeah it's a good point as as someone who

uh quote-unquote switched teams uh to a

new pump provider last year you could

definitely vouch for that of you know i

do have some spare emergency supplies

but they wouldn't be uh they wouldn't

synergize the system i use now so when

in doubt keep it on you know simplify

use the same same thing

um we have someone who shared a story a

little bit who said on a positive note

uh i went to germany and forgot my extra

insulin i found out that in most

countries in europe you can get insulin

without a prescription so that is

helpful for anyone traveling to

uh you know the european union or the eu

27 uh

you know that's that's a pretty pretty

solid advantage especially in

considering chris your story about uh

the hassle that you went through in in

the united states to get to go through a

doctor get a full-on prescription

and pay for that

so a bit of a bit of solace to anyone

who's who's europe-bound or wants to be

europe-bound

that's right yeah

that's what you're gonna deal with and

and that can be motivating and at least

you know right so that something was to

happen you know what you have to go

through and it becomes less stress when

you have that information for yourself

yeah great great story there

um i have someone who is a relatively

new type 1 diabetic so first of all

thank you for for tuning in and i hope

you

have the chance to to get some travel

relatively soon um and then this

person's asking they were advised that

they require a medical note to show when

they travel

can we can you advise from your

experience sort of the process to go

through for that and what it's like

so personally i do have medical notes

from my endocrinologist

and i think i even have one from my

family doctor

i've been through

you know hundreds of airports around the

world

i've never had to show it

um however i do have it in you know in

my little travel medical bag

if i'm ever asked for it but um

but i've never

actually had to provide it to anyone

yeah

um and similarly i've never had to

provide it except for one time

and uh this is actually um for the most

people are aware of the liquid ban and

now that's been rescinded a little bit

but at one point when the liquid bomb

first happened it was in heathrow

airport and we had actually just flown

through heathrow to get to italy and

then we were going back to heathrow

which is in um

it's in london so uh anyway

we were going back to that airport and

this was after the bomb scare it

happened

so

when going through the airport in italy

they said absolutely no liquids and i

had my bottle of insulin

um and i was trying to explain to

somebody and they they were saying no no

no and then i had my medical note so

they end up bringing it to another

person and that's why i said like one of

the things i've learned over time is

just keep your cool

somebody will come along who will

understand um and try not to get as good

because i thought you know

i'm not going to throw away my insulin

here this is this is crazy but

they just needed to understand so

luckily i had that little form and so

that's the idea with the form is that

when you do need it at least you've got

it um it's going to be helpful for you

hopefully you're like us with lots and

lots of other travel experiences where

you don't need to have anything like

that

and thanks for that question because it

can be especially as a first timer it

can be a bit confusing to know what what

pieces of paper do i actually need to

prove this or to justify this so

better better to have it than to not

um we have a question regarding uh where

to get coveted tests before flying so

they say several types and the most

convenient and reliable ones

since they need to be done two days

before flying

um so any recommendations on getting

that done i i

was my inclination would be toward a

self-directed test but i'd be curious to

hear your folks thoughts

yes so um as far as that goes it really

depends where you're traveling to um

every every country does have different

requirements um

so there are some countries that it

could be 96 hours before you you land

others three days before you depart um

sometimes 48 hours and and i've helped

clients some with you know getting

numerous tests um for those of us and at

least and i can speak to ontario

shoppers drug mart and many other

pharmacies do provide travel

pcr testing

so i would recommend that's probably the

best way way to go is to speak with your

local pharmacy and

and see if they provide that that is the

current and then of course when you're

when you're in destination and again

depending where you're traveling um in

the u.s sometimes you can have results

within an hour um you know i know of

clinics in

cairo egypt that it's a drive-through

testing facility and your results are in

12 hours um so you'll really need to

speak with somebody who either your

traveling on the travel professional or

you know someone in destination to let

you know where to get it to return home

to canada um but in canada i think your

best bet is really going to be

speaking with your local pharmacy and

finding one that offers those services

and there is a cost i think it's over a

hundred dollars but

no if you're getting to explore the

world it's a small price to pay

thanks amanda and i i think i'll add the

caveat that it's not necessarily uh an

expense depending on province so there

are some problems for example here in

the atlantic region where they they are

free um but i would just look into that

depending on on where you live what the

what the deal is with

receiving a pcr test because it can vary

i have a question that is

specifically served around this idea of

calming the nerves or you know is

self-directing uh how we how we bring

our own attitude into what can be a very

stressful or overwhelming experience and

have a viewer asking if you have any

recommendations or ideas for

meditations that are easy to do and can

help calm the nerves or if that's a

practice that that you folks use

i'll share i'll share what uh helped me

and so i mentioned a little bit about my

height um so i guess like when you first

get into an uncomfortable position you

tend to complain about it right and then

here i was on a national rowing team

with everybody being you know six three

six four six six

and so everybody's starting to argue

about who's gonna get the best seat on

the plane

and i just started to think about it

myself like who do i want to be and

that's a you know a different way of

meditating but thinking about over and

over again like in this situation what

kind of person do i want to be how do i

want to contribute and how do i want to

see this

go and so i would often find myself just

quickly you know taking the uh the

window side seat um or right in the

middle of of the the row where there's

three or four people

and finding myself quite happy there

whereas you know um

if you if you look to see how other

people are responding

you might want to think okay i see that

this person is upset how can i respond

differently and so i just tried to get

that into my mantra um so that i was

always trying to take the the road that

would would lead me to be the type of

person and the type of experience that

i'd want to to be experiencing myself

and that that really helped me with my

my travel experiences and i remember

quite a few

experiences that were challenging very

constricted um

but but working through those in in

peace with myself and the people around

me so i think that's a one strategy

yeah and and i would add to that and i'm

a terrible person for last minute

packing

leaving for the airport at the last

minute but those times where i am

prepared and i'm packed a few days in

advance or even the night before

and

i'm leaving to get to the airport four

hours before my flight um i do find that

you know not being stressed about the

traffic i'm sitting in or throwing

things into

into my backpack um minutes before i'm

leaving

that really does help with my overall

peace of mind as well as

my blood sugars i i generally when i

have been prepared in advance and early

to the airport i don't see the same

spikes as when i'm racing through the

terminal to get to the gate

thank you thank you folks um so i think

seeing no more questions i want to say

thanks to everyone who who did submit

the question i really appreciate a lot

of the

the angles from which you're approaching

this so and i also get the sense that

it's as much as it can be a challenging

one to prepare for travel is by

definition such an exciting uh you know

full of potential energy so i can tell

there's a lot of you know excitement

behind the stress almost and i hope that

this has helped to to clear up a bit of

that that uncertainty or anxiety

um

before we wrap up i'd like to just take

a moment to tell you tell you folks

about how diabetes canada is helping

support you as we prepare for a return

to travel or more frequent travel so you

can visit our website and our social

media to stay up to date on what we're

working on and and resources that were

we put out

and for specific direction on this if

you have any specific tips or questions

that you didn't didn't get answered

today

you can call our helpline at 1 800

banting or you can email info

diabetes.ta for any questions

you can also specifically on this topic

check out as mentioned diabetes.ca

air travel

and that'll have all the resources we

have around this this topic including uh

you know how to access resources like uh

like a medical note packing lists and

more

so i want to give a huge heartfelt thank

you to our guests amanda gill and chris

jarvis for a really fantastic

conversation thank you for making the

time and sharing some of your your

expert knowledge on this front um before

we wrap up any final remarks to our

viewers

uh well i would love to share you know

on that note of the excitement apart uh

definitely the eating is one of the

things that's caught me off guard on

travel

so i remember in brazil there was a

restaurant that we went to that was all

meat just circulating platters of meat

and

and so it was a delicious night but i

didn't realize that if you eat a large

portion of fats and proteins that it can

also affect your blood sugar and so i

had a really rough night after that and

so sometimes you know using those

moments of reflection to realize that

you're learning um so that was a night

where i probably ate

more meat than i'd ever eaten before in

my life but i didn't have a lot of

carbohydrates and so the uh the blood

sugar didn't start spiking until about

three or four hours later um but i just

like you know just welcome you all to

think about that wonderful experience i

i will never forget that restaurant

and uh the night afterwards you know

that that's not a big part of it right

so we we might suffer a little bit along

the way as we explore and open up new

horizons but we're also learning and i

know better to how to manage that for

next time so i encourage you that as you

go and explore your your new horizons to

uh to keep coming back to these

resources and reaching out for support

as we learn together

yeah and on that note

you know

it's okay to not be perfect all the time

and

and it can be especially hard to stay

under control when you're in a new

environment and eating new food so don't

beat yourself up just correct

and enjoy the rest of your day um

because it's all new for all of us when

we when we go new places so do your best

to enjoy and not beat yourself up if you

do have a spike or a low

thanks so much folks um

so with that we'll we'll wrap up and i

just sincerely hope that this webinar

has been helpful for for you all of our

viewers i know i

was super appreciative of this

conversation as i'm gearing up for some

travel myself it's really really

wonderful to start thinking about this

stuff and

on that wonderful point of you know it

can be a really difficult hand to to

travel with diabetes but that doesn't

mean you can't pursue all the wonderful

learning and experiences along the way

it's just one

one extra hurdle that's that's on the

path to a great experience

so please feel free to contact us at

diabetes canada for any any info or any

questions

and thank you all and take care happy

travels