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Have Pump, Will Travel: A Birthday Excursion

April 29, 2014

The Basilica Notre-Dame, which was located about two blocks from our hotel.

With Meg’s birthday approaching, I figured we should do something fun and exciting. A trip would fit the bill, so I booked a nice getaway four-day weekend for us in Montreal. (I also successfully kept our destination secret from my love until we arrived at the airport. The gauntlet is thrown down for my wife for the next milestone birthday.)

As soon as the trip was booked, I was aware this would be the first time I’d be traveling with my pump in tow. I researched and researched and read as much as I could from all the diabetes bloggers and sites out there to see what I could expect, and what would be the best way to maintain balanced sugars while flying to our destination.

Most of them said the same things: test frequently; sugars tend to rise during air travel; notify our good friends at the TSA that you are wearing an insulin pump; etc.

After reading frequently that air travel can bring about sugar spikes, I thought “I’ve never really had a problem when traveling while I was injecting. Why would it be different with a pump?

After even more research, I came across this incredible post from A Sweet Life, “What You Should Know About Flying with an Insulin Pump.” It points out that the sugar spikes are not caused (exclusively) by stress, which causes the liver to pump excess glucose. No, this answer makes a little more sense.

As the author, Melissa Lee, points out, “It’s a matter of physics.” You see, when the plane is taking off or landing, it causes changes in the cabin pressure. This change in pressure causes fluids (insulin) to react differently than if they’re staying at sea level (or wherever you happen to be when the plane is taking off).

I read her blog entry and thought “How have I not read this before?” I checked Medtronic’s website and saw they don’t acknowledge this phenomenon. (Neither did anyone else, other than Asante, who were Melissa’s source for this info.) Medtronic’s “Travel” section of their support page points out important airport security info, and ways to contact Medtronic’s support teams from anywhere in the world. All very important. However, it lacks this piece of advice (taken directly from Ms. Lee’s post): “When flying with an insulin pump, you should always disconnect it during takeoff and landing.”

Seems counterintuitive, I know, but after reading her article, I was all in.

We arrived at the airport. We ate a nice breakfast. I checked my sugar. All was good with the world. We boarded and were ready to go. The plane approached the runway and, as our speed built up, I disconnected my infusion set from my body. Then I watched.

Bubbles started to form in the tubing. I showed Meg. More and more bubbles. Lots of bubbles. When we reached our cruising altitude, I purged the line to get the bubbles out. (Actually, I set it up as if I were putting a new reservoir in. Then primed the line to get rid of all the bubbles.

For the hour and a half duration of our flight, my sugars were steady and I didn’t have a single problem. As we prepped for landing, I disconnected again, but this time I took my reservoir out after detaching. I wanted to see what happened to the insulin in the reservoir, to see if it reacted the same way my tubing did.

Boy, did it. As we approached the runway, my reservoir started to resemble a sprite can that had been opened. Bubbles started forming throughout the reservoir, even more than I had anticipated. I showed Meg. I started tapping the sides of the reservoir and couldn’t believe the amount of bubbles that were floating to the top.

When we landed, I made sure to get all the bubbles to the top of my reservoir and put it back in, starting the process again, as if I were beginning a new reservoir and infusion site. I kept the reservoir upright, so the bubbles wouldn’t float all over, and kept the tubing straight up. Using one hand, I primed the line, and kept a close eye on the tubing to make sure I could see when the air bubbles stopped and the insulin started.

In all, it took a little over 20 units to clear all the bubbles, and my glucose stayed fairly balanced through the whole process.

On our return flight, I missed some bubbles on takeoff, and had to do some midair bolusing to curb a sugar spike. All in all, though, things went pretty smoothly.

And to think, the best way to keep balanced glucoses during air travel was to detach from my pump. Who would have thought that?

The trip itself was very nice. The weather was less than agreeable (high 40s to low 50s for just about the whole trip, and rainy weather Saturday and Sunday), but the city is beautiful. We stayed in Vieux Montreal, within walking distance of several nice restaurants and sights, like the Basilica Notre Dame and several museums.

And we ate. And ate. And ate. I fell in love with poutine. I enjoyed a smoked meat sandwich. I tried to keep stay as accurate as possible with my boluses. We got through the weekend with just one minor hypoglycemic event (fixed by a chocolate on chocolate Tim Horton’s donut — it was vacation, after all) and just a couple minor spikes in blood sugar. All in all, I’d say this was a successful first trip for my pump and I.

And I think it was a pretty good birthday present for my beautiful bride.


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