Here’s what Alex has to say about travelling with diabetes…

1. Hello! Please could you introduce yourself – name, age, how long you’ve been diabetic?

Hi. My name is Alex Williams. I’m 52 years old and have lived with type 1 diabetes for 36 years.

2. Where have you traveled?

I’ve travelled all over the south east coast of Australia, from as far north as Townsville all the way down and around to Adelaide. I can put my hand on my heart and say that I’ve probably driven on every stretch of highway in the state of Victoria. I started travelling the minute I got my driver’s license at 18 and haven’t stopped since.

My international travel started 25 years ago when my soon-to-be wife took me to “meet the family” in New Zealand. I was blown away by the beauty of the North Island and caught the travel bug there and then. But how do you describe to someone who has never done it, the adventure and curiosity of seeing an airport in another country, and then the strangeness as you drive through the city for the first time?

I’ve been back to New Zealand once since then, but as we were staying with family, there wasn’t a lot of diabetes adventure involved.

Fifteen years ago I got a job in Saudi Arabia. I travelled there on my own for the first trip and shared a flat with another westerner for 12 months. Then my wife and children were able to come over to join me in Riyadh, where we lived for the next 4 years. Each year we would do an international trip somewhere. Sometimes it was back to Australia to visit with family in both Brisbane and Melbourne, and sometimes it was elsewhere. During this time we did a 4 week driving tour around Great Britain in a Kombi Campervan, driving almost as far north as John O’Groats and south to Southampton. We spent a week in London just enjoying the history, the culture and the sheer joy of being there. http://www.geocities.com/alex_of_oz/Saudi_pages/Pommy_trip.html

During this time we also did a 5 week driving trip around Western Europe, flying from Riyadh to Paris via Jeddah and then driving from Paris to Luxemburg, Germany, Austria, Italy, France, Switzerland and then back to Paris. We stayed in Paris for a couple of days, and then caught the overnight train to Rome, where we stayed for a week of walking. Many interesting things happened including nearly getting arrested in Rome. http://www.geocities.com/alex_of_oz/Saudi_pages/Europe_99.html

I also managed to squeeze in another trip from Riyadh to Glasgow, this time for business. The interesting thing about this trip was that the night that I was flying into London before swapping to the plane for Glasgow, was also the night that Princess Diana died in Paris. My whole trip to Glasgow was over-shadowed by Diana’s death. I caught the train from Glasgow to London on the day of Diana’s funeral. That was an experience that I will never forget. The flowers arranged around the gate to St James Palace were truly incredible.

Travel took a back seat for a few years until about 2005, when I travelled to Bangalore in India for four and half months. This was a business trip in which I was meant to train them up so they could take my job. I still have my job. This was also the first time I had travelled in a third world country, so the food, hygiene and medical side of things were interesting. All went well with few dramas. While there I wrote a number of stories, with one focusing pretty much on my being diabetic – http://www.geocities.com/alex_of_oz/Bangalore_stories/Missive_8.html

There is another story that talks about the time we were travelling between cities and I started to have a hypo. That can be found in the India stories here – http://www.geocities.com/alex_of_oz/Story_index.html

The last trip I did, which was 3 years ago, was a 4 week trip back to Bangalore. This time the food caused me some difficulty because I was staying in a serviced apartment where I was reliant on other people providing and cooking the food. You don’t realize how reliant we become on our “western” time schedule until you are living in a third would country where time is much more flexible.

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

For me, the most difficult thing about travelling with diabetes is keeping track of where there is a reliable source of food, 24 hours a day, 7 days a week. For example, lying down on the public seating benches at Rome airport to stay until the first plane left in the morning, only to discover with 2 minutes to spare that the food shop that we can see just across the walkway is not staying open all night as expected, but is about to close and won’t open again until the plane is airborne. And guess what? I don’t have any emergency food in my bags.

Another difficulty is the effect that the jetlag, time differences and physical and emotional stress has on the sugar levels. There is an underlying constant awareness that the sugar level can plummet at any moment, which is especially stressing when travelling by yourself. This happened to me while in a hotel in transit in Bahrain; the sugar plummeted and it took me 2 or 3 or 4 hours (see what I mean) to get it back. However that was not in time to catch the airport shuttle bus!

4. How prepared were you before you left?

I believe I have experienced most things a diabetic can experience while travelling, and learned from the experience. Yes, I have woken up in intensive care in hospital in Riyadh, Saudi Arabia after having a massive hypo. I needed to go under a general anesthetic so they could put my arm back in place. I had managed to dislocate my shoulder while having a fit in the hypo.

I have found myself without food, and learned from the experience. I have found myself with nowhere clean to have my injection, and learned from the experience. I have been challenged by the customs officers in Jeddah airport when they saw my injection kit, only to be deflated when I told them “Sucre dam”, which means “sugar blood” in Arabic, which is their way of referring to diabetes. I learned from the experience.

And I’m sure I will learn more when I travel to Morocco and walk across the Sahara desert.

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

• Always carry a doctor’s letter
• Always carry extra insulin and equipment
• Always have emergency food with you that is robust
• Always know where food can be obtained
• Write lots of lists, to reduce the stress level and therefore the hit on sugar levels
• Always pack your medical kit and emergency food in your carry on luggage
• Maintain 2 medical kits; one for your carry on luggage and one for your suitcase
• So long as you plan properly, there is no reason why you can’t travel
• Finally, NEVER rely on airline food

And as if to still any residual fears I had about travelling with diabetes, I’ve just made contact with Lara Mckane – another young diabetic who’s travelled through South-East Asia and has some words of wisdom to share with us… What great timing!

1. Hello! Please could you introduce yourself – name, age, how long you’ve been diabetic?

Hi, my name is Lara Mckane. I’ve just turned 29. I was diagnosed with type 1 diabetes when I was 21 – so I’ve had it for roughly 9 years.

2. Where have you traveled?

Well, after studying I went overseas to work in the UK. While over there I was diagnosed with diabetes. After living in the UK for 3 years I went backpacking around Australia with a friend for a year. From there I raised enough money to travel South-East Asia (Thailand, Cambodia, Vietnam and Laos for a further 8 months.)

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

I love hiking… While in Cambodia we did a few hikes over numerous days, and although this wasn’t difficult it took some planning – making sure I had enough food and glucose in case of emergencies. Also making sure my insulin was kept cool in 3^rd world countries where not having fridges is common practice.

4. How prepared were you before you left?

I did alot of research and preparing before going to Auz – making sure I could get the correct insulin while over there and that I had adequate medical cover in case of emergency. Asia, however, was a different story – I didn’t prepare at all other than taking adequate supplies of medicine and snacks.

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

I think it’s important to do research into the country before leaving – things like can you purchase a similar insulin, similar glucose strips etc over there. Also take a cooler bag or ice bags with you, to keep your insulin cool at all times – because you never know if you may break down for a few hours at a time.

Don’t let something like diabetes hinder your dreams – as long as you look after yourself and prepare yourself adequately there is no reason why you can’t do anything you set your mind to.  I’ve dived the barrier reef, hiked through the jungle, sky-dived and still dream of climbing Kiliminjaro.

Which, for those of you outside of South Africa, is the biggest health website in the country.

Check it out! www.health24.com
Front-page story about our upcoming trip… Fame at last!
And it’s a really lovely interview.

Now I’m off to run errands all morning – chat to you later!

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!