Exotic Brazil pics (here and below)

Here it is, as promised! The second half of my interview with the very inspiring, very well-traveled Martha Iskyan. For those of you just joining us today (go and read yesterday’s post first!) Martha and her husband, Howard (a Type 2 diabetic) have travelled pretty much all over the world, and have very kindly agreed to share some travelling tips with us.

Here goes…

4. How prepared were you before you left?

We were very prepared.  We knew how we would get from the airport to the hotel or B&B or wherever we stayed the first night, so that there would not be any anxiety or confusion about that.   After that first day/night, we could plan what we wanted to do by reading the Lonely Planet, our travel “bible”.  We also had car rentals reserved online, before we left, since that is much cheaper than walking into an office and renting a car.

We had a general schedule of staying in one city so many days, but if we did not like the place, we left earlier, or if we liked it, we stayed longer.

We travel light: each one medium sized expandable suitcase on rollers, each a small pack-back, Martha a small purse that fits under her jacket, and Howard a small flat envelope-sized bag around his neck with important credit cards and extra cash.
When we walked in cities, I kept a small amount of money and one credit card in my sock.   Each of us had two different credit cards, in case one card would not work, another would.  ATMs the world over are fickle!  Particularly in Brazil!  Some cities still run on an ancient CIRRUS system, and our cards would not be accepted in the whole city!   HSCB banks are the best and always took our cards.

5. Do you have any hints or tips for diabetics who want to travel?

Some hints: See above… and more…

Clothing for different climates was a challenge.  We found that being able to “layer” was the best; i.e. 2 pairs of basic pants:  several tops with short and long sleeves, fleece jackets, one heavy sweater, and a windbreaker jacket with a hood.  It looks like your schedule takes you mostly to warm climates during the time of year those countries are in summer.

Every day, I inspected Howard’s feet to ensure there were no blisters or athlete’s foot and toenails were short.  I gave him foot massages for circulation using a good all purpose cream.   We brought flip flops to use in bathrooms.

If you feel a cold or fever coming on, or have flu symptoms, go to the doctor immediately.  We cannot stress this enough.  Do not rely on remedies of pharmacists.  They want to help, but cannot prescribe antibiotics and that is what you need to take.  (However, pharmacists are very good at giving directions when you are lost.  They usually live in the city or village, are intelligent and speak some English.)

Always travel in two’s.  I noticed when Howard would get tired or sluggish, before he realized that his sugar had dropped dramatically, while we were walking.
The way to get his carbohydrate level up was the universal great drink: BEER!   How he enjoyed that!
It also gave us a time-out to regroup and review how much more we were going to walk, see, or decide if it was time for lunch.
We usually had one large meal a day: lunchtime.   During the day we would purchase some whole wheat bread, cheese, fruit, drinks, (beer or maybe a small bottle of wine) and enjoy this in the hotel room in the evenings.

Take one regular syringe with you, just in case your pen doesn’t work, for some unexplained reason, so that you can still draw the insulin out.  We have had this happen twice now.  That way you do not waste the whole pen, if there is still a lot of insulin left, and you will not run out, since you will take exactly what you need!

Make sure you have prescriptions for every medication you take, in case you need a refill, but also to show to the airport control, if they question your insulin pens. (We have never had anyone question this, but you never know).

Do not carry anything more than 100CC of liquids or creams in your carry-on bags, nor scissors.
We had a small blanket in the backpack to sit on, or to use if we were cold: a spoon, fork and small knife and bottle opener.    We also brought or bought a small bag of whole grain cereals, to eat for breakfast if there were only croissants and coffee  (often the case in Argentina and Chile).  Brazil has by far the BEST breakfasts anywhere!

In restaurants we asked for vegetables instead of the daily ration of chips and rice.  We never had any questions about that.  Sometimes, we had to pay a little extra, but that was worth it.   Try to eat only peeled fruits or fruit that you can peel yourself, and cooked veggies, to ensure that you are not getting some bug.

Most of the time we drank the water out of the faucets, but it is probably advisable to have bottled water for night-time drinking.

We had a check list that we used every day, either before leaving on a daily outing in a city, or when we left the hotel.   I would go over the check list and we both would say, “got it.”  My job was to look under the covers and under the bed(s) and check the bathroom, as the last person leaving the room.

Have an awesome time, enjoy every moment and above all, relax and take the ride in stride!    Howard and I are intending to make a round-the-world trip, if and when he retires!
We will then see the places we have not seen yet!

What a serendipitous week this has been!

I was being interviewed on the radio last week, and Martha Iskyan happened to be listening… She emailed me straight afterwards to say that her husband, Howard, is diabetic, and they’ve travelled all over the world – to many of the places we’re going! I immediately asked if I could pick her brain and learn from their experiences. And what a lot of experiences they’ve had!

Here’s what she had to say:

1. Hello! Please could you introduce yourselves – names, ages, how long your husband has been diabetic?

I am Martha Iskyan, 63 years old, married to Howard Iskyan, 69 years old, who’s been diabetic since he was 33 years old.   Diabetic for 35 years now.  We’ve been married for 42 years in September.

2. Where have you traveled?

We have lived in the US for 30 years in 12 different States. 10 years in Madrid, Spain, 2 years in Johannesburg, and 8 years in Cape Town, South Africa.  We have a house in Pittsburgh, Pennsylvania, where our daughter, Kara lives.  She is an internal and trauma medical Doctor.

We have traveled in Latin and South America to:  Mexico, Guatamala, Costa Rica, Panama, Venezuela, Curacao, Netherlands Antilles Islands, (Martha was born and raised on the island), Ecuador, Brazil, Uruguay, Argentina, Chile and Peru.

In Europe:  We have an apartment in Amsterdam, Netherlands, where we spend a lot of time.   Lived in Spain for 10 years and saw all of Spain.  Martha lived in Portugal for 4 years.   We have traveled to:  Belgium, Luxembourg, Germany, France, Switzerland, Austria, some of the Balkan countries, Greece, Italy, Sardinia and Istanbul (not Turkey itself).

The Near and Far East:   Bahrain.  Martha lived in Tokyo, Japan and Sydney, Australia for 1 year, each country.  We visited Singapore and Thailand and Hawaii in the Pacific.
In Africa:  Gabon, Ghana, DRC, Angola, Namibia, Mozambique, Zimbabwe and Zaire.

3. What was the most difficult thing about traveling with diabetes?

Adjusting the long term insulin to the time zone changes, especially going East or West across the Oceans.   Howard would set his stopwatch when the plane lifted off and stop the watch when we arrived.  He would adjust his regular watch to the time of the country that we would arrive in.  We paid particular attention to the pilot giving this information, or asked the flight attendant to get this information for us.    The stopwatch would keep track on when the long term insulin had to be taken again.   This meant that it was sometimes at 11am, whereas at home he would inject at 7am local time (because of the 6 hour difference in time, going forward).

Howard had made a daily schedule for each month, on which he recorded each glucometer reading and subsequent insulin amount injected.   This way he could keep a record.   This was for both himself and the Doctor to see a “trend” if there was one of highs and or lows.

Adjusting meals and snacks to somewhat “normal” times, while flying, was a juggle, because meals came right after take-off (whether it was 11am or 2pm), then there would not be anything served for 8 hours!  Each airline has its own peculiarities.

We ALWAYS had sandwiches, fruit, nuts and raisins, cookies and, oh yes, chocolate.  We asked for a small carton of fruit juice every time the flight attendant came around, but kept this in our little “stash” bag.

Howard kept the insulin he needed during the flights and during the day when we were “on the ground” on his body at all times, so that the temperature stayed about the same all the time.  The extra insulin was in the suitcase, some in mine and some in his and some in my backpack and in his backpack.  (I read that you have already thought of that).

Howard had a jacket on that had many pockets, so that he could have his glucometer, insulin, baggie of nuts and raisins, cleaner wipes, or small bottle of gel and a small tube of antibacterial cream, bandaids,  one pair of clean socks, little woolen hat for drafts in airplane and hotel/B&B rooms, 10 paracetemol, (if you feel hot or feverish, take 3 and the fever will go down by the time you arrive at the airport, so that you are not send back with the next returning plane!), passport, inoculations card and money on him.  Do not rely on anyone else to carry “your diabetic stuff”!

We suggest that you buy a packet of protection masks and put one on in the airplane (and remove this before deplaning).  You do not want to raise suspicion that you might be sick, but it will keep you from getting the bugs that are so generously “flying” around the plane.

Try to get seats in the middle of the plane over the wing, and ask just before boarding if you can have 3-4 seats for the 2 of you (if plane is not full) so you can stretch out and put your legs and feet up.   I would massage Howard’s feet regularly on long flights and he would get up and walk and do knee bends in the aisle, every 2 hours. These are just a couple of the things that helped make the trip easier for us…

(Another pic from their travels in Ecuador)

What a wealth of information! And there’s more – this is only half of the interview. Check back tomorrow for more priceless Travelling with Diabetes tips!