I had a recent appointment where I shared a laugh with the person receiving me at the fact I was carrying a backpack to said appointment. The irony is that the location wasn’t all that far from my home and the appointment would likely only take about an hour but as a responsible person who has Diabetes, it’s up to me to have everything I need in order to ensure I don’t run into issues.
For the most part, unless I know that the outing/errand I’m running will literally only take five minutes (for example, going to my 7-11 convenience store on the corner) I bring a bag with me. This bag contains AT LEAST the following: nasal spray, hand gel, blood sugar meter, cereal bars and jelly beans, a book, my iPhone’s earbuds and business cards for my blog. Yes, I have business cards for my blog. It’s much easier than trying to give someone the website address…
If I travel to any great distance, for example flying back to New Brunswick, my carry-on bag will contain all the above-noted items as well as reusable insulin pens that simply require me to step into a pharmacy and purchase insulin over-the-counter should my pump fail or I run out of pump supplies. I started taking that last precaution after an issue I ran into last September when I returned home for some job interviews.
Usually, I’ll calculate my equipment needs for all my absent days, plus three. This means that I should have enough supplies to last me three days longer than my intended trip. That way, should there be flight delays, equipment issues or problems along the way, I’m all set. But last September, I flew to Fredericton, New Brunswick for a full week on a job competition. This meant I would need at least three pump change-ups with a fourth set to accommodate any failure or delays, and about 600 to 800 units of insulin for those seven days. Sounds reasonable, right?
During the second or third day that I was in Fredericton, I received an email from one of the other agencies in New Brunswick I had applied with and they required that I attend in person for an interview the following Tuesday. This meant that my seven-day trip would be extended to twelve days or more to accommodate the interview. I discussed what I should do with my wife and it was agreed that I should stay. All of a sudden, I scrambled to change my flights and cancel my hotels as I would simply stay with my family for the added days in between.
I still had plenty of Humalog (short-acting insulin), so I went to a local pharmacy and purchased disposable syringes as well as a bottle of Lantus (long-acting insulin) in anticipation of my pump running out and no longer having access to an automated basal rate. In the end , I was able to stretch out my pump sets to accommodate the additional time and I made it home to Saskatchewan under the wire. But it makes me wonder: what if I were isolated someplace where I didn’t have the option of buying added supplies?
In my late teens and early 20’s, I went on a number of nature treks where a friend and I would canoe or kayak down the Restigouche River. We’d get a ride west to where we would “ship off” and time on the river would usually see us locked away from civilization for at least three days. I was pretty cheeky in my late teens, early 20’s and not always cognizant of the danger I may have been putting myself in. I always brought plenty of insulin and test supplies, but I’d be lying if I said I had plenty of fast-acting carbs to shore me up if I dropped. I had SOME, but probably not enough for a multi-day excursion that required me to paddle a canoe for hours on end.
So this begs the question: how does one deal with a situation where one has run out of supplies with no ability to obtain replacements? What if my insulin spoiled in the summer heat while I was out on the river? What if I dropped my pen and smashed the only remaining vial I had? These are possibilities that I would have to deal with. I’ve always been pretty careful have luckily never had to deal with such situations, but being two days or more away from civilization would throw a serious damper on the trip.
I wrote a post last April entitled Don’t Fear The Reaper, Kick His Ass Instead, which covered off some of the issues that one could face and how long a Type-1 Diabetic could live without insulin. You can click the link to give it a read, it’s pretty bleak. The reality is the average Type-1 Diabetic has a life expectancy without insulin of about 7 to 10 days at most. Nice, eh? And that’s under some pretty particular conditions. Having an adequate supply of water to stave off dehydration is a great start, since most adults can only survive three or four days without. And bearing in mind my scenario involves being on a fresh-water river, I’d likely be okay in that regard (barring bacterial contamination from drinking river water).
I had linked an article posted on Healthline.com that explained that without insulin, your body can’t use glucose as fuel and begins to break down fatty tissue as a replacement, which causes those fats to turn into acids called ketones. These ketones build up in the bloodstream and eventually get expelled through one’s urine. However, when these ketones accumulate in the bloodstream, your body chemistry begins to change and the blood starts to become acidic. This causes a condition called Diabetic Ketoacidosis.
Any of the even moderately serious side-effects of Diabetes could kill you, including dehydration or hunger, but if you manage to make your way through all of that, DKA is what would do you in. What to do if you’re in a life-or-death scenario where you don’t have access to a hospital or extra supplies? There isn’t really a happy answer. The reality is that you’ll likely expire, unless you’re some sort of super-human Diabetic who can stave off all those symptoms for a longer period of time.
Situations are much easier to deal with nowadays with the common use of cell phones. Back when I used to travel the river, cell phones weren’t a commonality yet. At least in the modern age, you could potentially call for help so long as you can find a cell phone signal. But even cell phones can fail, get dropped in the river, lack a signal, etc…
IS there a perfect solution to any of it? Unfortunately not. Diabetes makes for an imperfect life. But you can ensure that you take every precaution and make certain that you pack/bring/include everything you need with multiple extras. Having Diabetes absolutely doesn’t mean you can’t do any particular thing. You simply need to be prepared and take the precautions necessary to prevent finding yourself in a bad situation. Hope for the best, but be prepared for the worst. ☯