Category Archives: Diabetes and Travelling

Traveling with Diabetes

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I’ve travelled several times each month this year and it’s given me some lessons:

I’ve learned that I get motion sickness on planes and cannot travel without taking Dramamine.  I tried to forego it once and that one time we just so happened to have a bumpy ride.  It is not fun to worry about dropping blood sugars while throwing up and being jostled about in the tiny plane lavatory. 

Taking all the airport stairs and skipping the moving sidewalks (is that what they’re called?) is a good way to combat all the sitting involved in travel.

Staff on planes are always happy.  I still haven’t met one that isn’t, which is freaky, but if I’m feeling low, so far they are quick to grab juice if I need it and want to conserve my glucose tablet stash for later.

The food situation when in an airport is mighty tricky.  Temptation abounds and yet the easiest way I’ve found to travel is to keep it real low carb because if things get hectic, and lately in airports, they always seem to, low carb often saves me amidst skipped blood sugar checks.

Given how close one’s next seat neighbor is in coach, I find it remarkable how injecting insulin in front of that neighbor has never been an awkward experience.  In fact, it’s a great conversation starter and I’ve literally written down each starting line for your own amusement:

“Wow, those needles are tiny, I’m so glad for you.”

“So you have diabetes, huh?”

“OMG, do you need sugar?”

“Ok, what do I do if you pass out on this flight?”

“Wow, in and out, just like that, eh?  It takes me longer to sneeze.”

“How long have you had it?”

And my personal favorite:  “Does it hurt? I’m sorry, of course it hurts, what was I thinking? That was such a stupid thing to say, I’m so sorry, I didn’t mean to say that, I just figured that it hurts but maybe it doesn’t or maybe you’re used to it, is that it, are you used to it? Wait…I take that back, I get migraines and I seriously doubt I’ll ever get used to them.  Just forget I said that, ok?”  5 seconds later:  “So, where ya headed?”

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10 Random Things from the Author of The Girl’s Guide to Diabetes

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Hi!  I’ve been away from the blog longer than ever since it started 3.5 years ago.  That ends today.  But, here is what has been consuming my thoughts and making writing about diabetes a lower priority:

1.  Travelling with diabetes is challenging.  I’ve really been working at getting the knack of it.  I don’t want it to be bad for my health you know?  The other day, I tried my best to check my blood sugar in line at the airport where you put your things in cubbies to get scanned and just as I put the blood in the strip the scanner sucked my cubby with my meter in it inside to be scanned and I had to ask the lady at the scanner, “Excuse me, what number do you see on my meter?”  She lifted the scanner flap and peeked inside and said, “911 I think?”  Huh?!  It came out a few seconds later and I saw a 116, phew!  People behind me looked a little nervous and I don’t blame them.  One TSA agent said, “We need to do a pat down, do you mind?”  I said, “Of course you need to now, go ahead.”  What was I doing checking at the most inappropriate time?  I felt really off like I might be very low and ready to pass out and didn’t want to hesitate with checking because I had to run to the next gate so I felt I needed to just do it then.  I get sick to my stomach with flying so I take dramamine and that makes me kind of loopy…but I still love it.  Flying that is, not the dramamine.

2.  My favorite number is two.  I know that’s random but-My dad was diagnosed with bladder cancer.  It’s really scary because even though surgery removed the tumor, the likelihood of return is very high.  I’m making him vegetable juices and hoping that does something to help.  This has made me have a heart to heart with myself about my diabetes because I can do so much to make my outcome a good one-I really need to remember that and be grateful for it.

3.  My kids being 3.5 and still at home with me all day is driving me nuts.  I hate feeling nagged because I really am very happy to have them with me, to read books and play games all day, mold their minds into caring, open, patient people, watch them impressed as they have expert command of the computer, but at the same time, I know I’m not enough.  And I’m not sure how to solve this which leads me to:

4.  My husband Alex and I are having a hard time deciding where to live.  We can’t decide whether to rent or buy, to get a house or condo or loft.  And its because what we want doesn’t exist where we live.  We want to buy a really small place (so that the cost is low and the space is just for basic needs) and then we want to use our extra money to eat well (for health’s sake) and to travel (for our kid’s mind’s sake).  And I don’t mean travel abroad, I mean anywhere.  Right now just driving to a neighboring town to visit isn’t doable because rent is so high (since we want a nice and safe area-gee are we just asking for too much?).  When we walk out of our front door we want to be around people, a community.  I live in a place that is too large to be a town and too small to be a city and so we don’t have any of the best of either world.  Others would disagree but I must be ambitious because I want more.  Alex does, too.  We’re lonely.  There, I said it.  My kids are lonely.  School is coming for them and I’m sure they will love it.  Maybe that’s all we have to wait for.  In the meantime daycare/preschool is too expensive here and we make too much to get federal aid for it-nor do I want it.  Stubborn Sysy strikes again.

5.  I’ve noticed there is a back lash online towards people who are health coaches or something similar.  Usually, the most upset are those who studied for years to get an accreditation of some kind.  I can understand.  However, what someone like myself does as a health coach is in no way a threat to what a dietitian or a nurse or a diabetes educator does.  Think of what a coach does?  Supports, cheers, listens, encourages.  I’ll write more about this soon.  And I’d like for people out there to know that vocation has a lot to do with how good one will be at their job.  Just think, we all took math in high school but how many of us could teach others that math?  I couldn’t to save my life.  My health coaching training took one intense year but I’ve been reading and training on the subject my whole life as if I grew up knowing what I wanted to do only not knowing it actually existed until recently.  And I think that goes for many people of all types of professions and work.  I may write more about this later in detail but for now, I just want to say that health coaches don’t take the place of the other health care professions, they just want to help alongside of them.  And there is a need for them otherwise so many people wouldn’t be calling us for help and leaving happy and satisfied.  And we deserve to make a living off of it because we’re working hard, helping people (isn’t that the point?), and can’t do our work as homeless people.  We don’t have huge loans to pay back but that’s not our fault.  We do have to struggle more to find work since so many are still skeptical however.

6.  I’d like to remind you all of the website Guerilla Goodness.  It’s awesome and inspiring and really cheers me up this time of year.  Great ideas here for spreading around secret acts of kindness-which I agree with the author-do change everything.

7.  I’ve been thinking about how to reconcile my love of fashion and quality clothing while not spending much and while buying from small businesses and while keeping my closet simple.  A friend from France emailed me explaining what most girls there do:  They buy a few pieces a year that they carefully select while walking around town, making sure they fit perfectly and they get shoes that are comfortable but exactly what they are looking for.  Then, they wear the same few outfits over and over and over.  It keeps things minimal, lets them wear what they love, and keeps costs down.  And at the end of the year, they have completely worn out their shoes and clothes and can start anew the next year.  I read the same thing in a book recently, too.  Just thought I’d share because I think too many of us have too much clothes and we don’t even love most of it and then our closets are overwhelming, we’ve spent too much, and for what?

8.  There is a website I want to share.  My type 1 friend Cynthia Zuber is on a holistic health journey.  She is doing great and it’s been very inspiring to get to know her and see what all she does to regain her health and maximize it.  She shares the most delicious recipes I’ve seen and just want to let you all know to check out Diabetes Light.

9.  Did you get the flu shot this year?  I didn’t though I can understand why some do.  I haven’t in many years.  So far, so good.  Things have been great since getting my Vitamin D levels up with Vitamin D3 supplements.  Oh and frequent hand washing.  Just wanted to share.

10.  My most popular post is about nerve damage reversal.  I am submitting an update here that as of December 2012, I have less foot pain than I have ever had.  In fact, I have had none this year.  I don’t know why.  I wonder if running bothers me (I’ve been doing more yoga and walking and less running).  For years I had tons of foot pain, tons!  Then as I regained control of my blood sugars the pain increased (which doctors told me could be due to healing of nerves)  Then the pain went away for 99% of the time.  I credit this lack of pain now to well managed blood sugars.  I thought I would halt damage by improving my sugars but it seems I’ve reversed some because of the lack of pain?  Pretty fantastic what great blood sugars can do.  Makes the discipline and healthy lifestyle so worth it.  Even if I just do it most of the time Winking smile  Anyway, I share because the possibility of less pain is a big motivator.

Take care, all.

xoxo,

Sysy

Travel and Diabetes Ramblings with a Stranger

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One of my favorite places in the world is the airport.  I knew early on the significance of such a place having moved from another continent to this one as a young child.  The airport is like a revolving door of possibilities and opportunities literally flying in and out all day in the most organized fashion we can manage.  Each trip to and from an airport includes new sights and faces.  Each trip holds a little mystery and anticipation.  In an airport we’re forced to be patient.  We’re forced to have faith in others, namely the pilot of the plane.  We’re forced to sit still and be one with our thoughts and observations.

It’s so healthy.

It’s true that frequent travelers tend to dash about, mindlessly hooked to their device of choice, but I think even they must feel much of the same.

The other day as I checked my blood sugar on the plane I noticed how uncomfortable it made the older man next to me.  So I started talking.  I explained what I was doing and why.  I shared the results, “141, I’ll take it!”  The man looked out the window and let out a deep breathe.  He said, “So many people have diabetes.  It’s going to ruin our country.”

“If we let it”, I said.

“Well, I’m glad you seem to be taking care of yourself but what about everyone else?  Why can’t people just eat better and exercise?”

I went into clarifying some myths and misconceptions about diabetes while the man listened intently.  Then I said, “I wish we could bring everyone out on a trip somewhere and educate them all about diabetes and health here in the airport.”

The man laughed out loud and furrowed his brow at me.  “Oh?  Why at an airport?”

“I don’t know, just seems like a good place for all sorts of educational metaphors to really click.”

“Oh? Tell me more.” he said.

“Ok…well, just as with travelling, living life with diabetes is full of possibilities and opportunities.  In fact, every morning we get to face a new day with blood sugars that haven’t happened yet and strive to make the best of them.  Each day we have the power to choose what we are going to do with our health, you know, what we’ll eat, whether we’ll exercise or not, and how we’ll approach challenges.  We can get organized with our lifestyle habits and diabetes management routine for better, more consistent results.  We can choose to take inspiration and support from everything around us, from the people we encounter to the day’s weather.  We can learn to accept the risks of living with diabetes and not let them slow us down just as we choose to get on a plane so we can go somewhere even if we’re scared to do so.  We can learn to handle anticipation so we can move past unsightly blood sugar results.  We can learn how being patient doesn’t mean we have to wait forever and that eventually, we’ll get where we’re going.  We can learn how to trust others and ourselves to do the best we all can.  I just feel like the airport is a peaceful and safe place for learning, I don’t know.”

The man stared blankly at me for a moment and then scratched his head.  Then he laughed again and said, “And on the plane, we go over how to bring up diabetes with strangers by testing blood sugar in front of them.  Then they can ask questions, be educated, and hopefully feel compassion and understanding and spread that around.”

“See?  It would totally work!”

In between chuckles the man said, “It did, today.”

Interview with Type 1 Living Abroad, Ariana Mullins

 

Remember earlier this year when I interviewed Nathan ShackelfordHis blog is still one of my faves.  Well, he said I might like to check out his sister’s blog.  Ariana Mullins has type 1 diabetes like her brother, but doesn’t blog about it.  Instead she blogs about her family’s adventures living in Europe.  She is a fantastic writer (she just wrote my favorite blog post ever) and takes some amazing pictures.  Do check out her blog, it’s a beautiful reminder of what living a healthy, fabulous, and grateful life is all about.

I asked her some questions about how she manages her diabetes and what it was like having diabetes and living in Europe (and other places):

How long have you had type 1 diabetes?

I was diagnosed 21 years ago, at age 12.  By the way, I was diagnosed by my dad and his glucometer, and never even saw a doctor  about my diabetes until I was 14.  My dad and older bother are both type 1 diabetics, and we were living in a rural area in the Philippines. My dad helped me work out my insulin dosages, taught me to estimate carb counts, etc.  My brother sent me my first insulin wallet, (which I used for the next 15 years!)  I decided right away that I wanted to be healthier than any non-diabetic, and took everything related to self-care pretty seriously.  Six months after diagnosis, I left for boarding school, on another island– so I was really on my own!  When I did finally see an endocrinologist, he was amazed that I had an A1c of 5.6!

What’s your motto in life?

“Never make decisions based on fear.”  I think I have lived this philosophy pretty well with my diabetes.  I haven’t let my diagnosis keep me from doing anything I really wanted to do, with the exception of snorkeling and scuba diving.  I used to snorkel all the time as a kid, but once I became diabetic, the idea of being in the middle of the ocean with low blood sugar was just too hard to justify!  Other than that, I have not let my diagnosis keep me from living as fully as possible, trying as many new experiences as I can.

Ariana and her brother, Nathan:IMG_1246

What is your diet like and why do you eat that way?

I eat low carb, and follow more of a paleo-type of approach.  I love food, and love to cook.  We originally started eating a grain-free diet because of food allergies that my daughter and husband have, but I quickly realized that it was great for all of us, and simplified my life a lot, since I was already not eating much starch anyway.  We eat plenty of meat and eggs, lots of vegetables, coconut products, and plenty of fat.  If we’ve been to France recently, then there’s plenty of great cheese on the table, as well!
I don’t crave a lot of sweets, but I do make room in my day for dark chocolate (usually 80%) and am happy to try out grain-free dessert recipes for my family, although I don’t usually eatmuch of those treats.  We always eat very well, though, with an emphasis on great quality items.  Who wouldn’t be happy to have a nice steak with herbed butter, grilled asparagus, olives, and a fresh, herbal salad for dinner?  Add a glass of red wine and some chocolate for dessert, and I feel like one lucky lady!  I never feel deprived, and absolutely love eating all of the great food at our table.

I think that one of the most positive, proactive things a person (regardless of health concerns) can do is to look at their food supply– what are we really eating, and where did it come from?  How was it produced?  Taking an interest in our sustenance is extremely rewarding, and eating well does not have to be expensive or difficult.  It’s true that eating quality food is a real priority for me, both in terms of budget and effort, but I don’t spend more than the average person (in fact, probably less!) and we feel incredibly wealthy when we sit down to eat together.

(Sysy speaking-she isn’t kidding.  Below is her cooking.  It’s what I want for dinner.)

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What in your opinion, is the toughest thing about living with type 1 diabetes?

I think the hardest part is just that it’s always there, on my mind, and impacting the smallest decisions in my day.  What I eat, when I eat.  The type of exercise I do, when, how long, etc.  Although diabetes doesn’t limit me much, it impacts everything.  When I leave the house, I have to think about whether I have something on hand in case of hypoglycemia, and whether it’s enough, or where I could get more, if needed.   And I am always counting…  The insulin I took, what I ate, when, what I will eat, what my last number was, what happened yesterday or the day before, trying to anticipate what my blood sugar might do.  There are so many variables– how much sleep I got, the amount of stress I am under, how old my insulin is, which ratio of insulin in my system is basal, how long a bolus dose will be working… The list of factors is endless, and it can be overwhelming at times, when there is a problematic dynamic happening that I need to figure out.  I can do everything “right” and still not get the numbers I am shooting for.  Diabetes takes a ton of mental energy and patience, and when other things in my life are a little wild, it can feel like too much!

Do you ever fear your daughter will develop it?

Yes, I do fear that she might.  Genetically, the chances are not too bad, but there is always that possibility.  Honestly, this is another reason that we eat the way we do– I want to give her the best health foundation that I can.  I do my best without being obsessive, and the rest is really not up to me.  It’s not something I think about every day, though, and it really wouldn’t be the end of the world if she did develop diabetes.

With her adorable daughter, Amelia:IMG_5617

Is it challenging living abroad with type 1 diabetes? What places have been the most challenging/least challenging?

I don’t find living abroad with this diagnosis to be much more challenging than living in the US.  In Germany, I did have to do more work to find a doctor that spoke English.  My diabetes is the same here as it would be anywhere else in the world.  I think it would be more challenging living in a really hot country, where I had to think all of the time about keeping my insulin cold.  Or a place that I couldn’t find supplies so easily.  But so far, it’s not hard at all.  We travel quite a bit, and that of course presents some challenges, but usually nothing too serious.  And of course,  the travel is so worth it!

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If you can’t find glucose tablets, what do you use for lows?

Fruit– I often carry an apple in my purse.  I can’t find Smarties candy here, which is my #1 choice.  Fruit leathers are pretty good, though, and if I am out and about, then getting a little bit of fruit juice is fast and effective.

How many times a day do you check your blood sugars?

This actually varies.  Since I have some limitations of test strip supply, I use a “save and splurge” sort of strategy.  I might use tons of strips for a few days, while I am figuring out a dynamic or blood sugar problem.  Once I have logged all of that information and have something to work with, I will make changes, and then check less obsessively, to see how things are going.  On average, though, I’d say I check 5-7 times per day.

Why did you decide to move abroad? Were you worried about how you would manage with your diabetes?

We decided to move overseas because we wanted to live in Europe.  It’s really that simple!  When we found out that my husband could get a good job working for the US government overseas, we jumped at the opportunity.  We lived in Germany for a while, and now we have been in England for over a year.
To be honest, my diabetes was not even a factor I considered when making the decision to move.  I think this makes sense, if you take into account my first years as a diabetic– completely self-managing in a foreign country.  I had not gotten exceptional care from doctors in the US, and the cost of insurance, co-pays and things like that never made me feel like I was particularly lucky to be a diabetic in my home country.  Once, I went to see a really great endo in Portland, and they booked my appointment and said they would accept my insurance.  But it turned out that they wouldn’t– I found this out after the doctor had run a whole bunch of labs (which just revealed that I was super healthy!) and we ran up a bill of $1,000 for that one visit, during a time of financial strain!  I could not even afford a follow up, which would have been the more valuable visit.  See what I mean?  There are great resources for diabetics, but not necessarily available to the people who need them.

So, here in England, the way they manage diabetes is not that great, either.  But they do cover prescriptions and supplies 100%!  Honestly, it is the patient that manages their diabetes, not the doctor.  So I would rather be empowered by having the supplies and medications I need, than lots of face time with doctors and nurses.  That said, there is a diabetes clinic nearby, and I can call one of the nurses, send them my logs, etc., whenever I want, for help.  The technology is a bit behind, though.  Not many diabetics use pumps here, since the funding is limited, and CGM supplies are not covered.  I am currently on a waiting list for a pump class, and then subsequently getting set up with a pump.  I don’t know how long it will be, and it’s not something I am expecting next week, I’m just waiting to see how it plays out.  Interestingly, you have to sort of prove your worthiness to get a pump– a reasonable A1c, and adeptness at carb counting and adjusting insulin.  I know these are kind of basic in the US, but I think it’s more rare to find PWDs who are very engaged in their own management.  This observation is simply based on the way things are handled– I haven’t met another PWD here yet!

What advice do you have for someone with type 1 who is considering moving to England (where you live now)?

I would recommend that they work to get their diabetes well-managed, through whatever resources they have available to them at home first.  It may vary depending on where in England they land, but I don’t think the management resources here are great.  They would need to be pretty competent with trouble-shooting and investigating issues on their own.  Sure, there are doctors and nurses here to help, but it could take a while to get an appointment at a diabetes clinic, or to find the exact type of help they need.  For example, if I had been working with a great endo before I moved here, I would have tried to set up a way to stay in contact with them, and pay for consults over the phone or via email.  On the other hand, if they qualify for NHS coverage, then they are going to love getting all their supplies for free!

The thing that most positively impacts your diabetes management?

A curiosity about the human body, and health in general.  Being diagnosed at a young age definitely sparked my life-long interest in health and nutrition.  Our bodies are really amazing.  They are always working hard to do their best, and deserve our best in return– the best nutrition we can find, plenty of rest, play, etc.  It makes me sad when I see people feeling angry with their bodies, or fighting them– the body is always working really hard, and never tries to sabotage us! The discomforts or troubling symptoms I may have are just forms of communication.  If I pay attention and respond, I can take great care of myself!  Don’t let the challenges of living with diabetes overshadow all of the really wonderful things that we are capable of through such exquisitely designed structures!

Where in the world would Carmen Sandiego be if she had type 1 diabetes?

Probably in Germany!  The best diabetes technology always seems to be coming from there, and they also have a great healthcare system that allows diabetics to get the care that they need, with minimal personal expense.

Any last words?

I don’t usually write about diabetes, so this was a positive exercise for me, in terms of articulating my experience with this condition.  Diabetes is actually not a big part of my identity.  I learned from an early age that I didn’t like being thought of as “that diabetic girl.”  People either felt sorry for me, or felt like they needed to get involved, or (worse yet!) tell me their best diabetes-related horror story.  No thanks!  Life is so interesting, and there is so much out there to experience, so I do my best to strike the balance between taking good care of myself, and just living and enjoying everything else around me.

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With her husband, Jeff.

Thank you for letting me share a bit about my experiences, Sysy!

Anytime!  Thanks for being so candid and helping prove that people with diabetes can do anything.

Travelling with Diabetes

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I’ve been travelling more than I’m used to lately and suddenly I’m really interested in what items to pack for my diabetes.  On a plane the other day I suddenly had the thought, “What if I use up all my sugar for lows and need more?”  Now typically on a large plane, there are sodas and juice but on the plane to my hometown there is no such thing because it’s a small bumpy ride home.

So…I want to ask those of you who have diabetes and travel from time to time or frequently, what do you pack in your carry on?  Do you travel with glucagon?  Do you bring tons of back up glucose tabs?  What do you do with your back up or extra insulin that you bring if there is no fridge in the hotel room?  Does that affect it’s function later?  Do you eat differently when you are travelling?

So many questions!

Advocacy On the Go

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Lately, I’ve made it a point to talk to whoever is next to me when I’m on a plane.  It’s almost like an exercise for me since I’m quite a bit reserved and introverted.  But I tried it recently and was so blown away by the experience.

Just the other day, I met a woman whose family endured the holocaust.  I talked to a little boy travelling alone who was my youngest brother’s age.  He talked about baseball like there was no tomorrow.  He was a gentleman too and helped me with my luggage!  And I met someone who has a twin and provided me with insight on how I might be sensitive to my twins while raising them.  And to every person I provided a lot of diabetes advocacy information.  I felt like a travelling diabetes advocate.  In fact, I guess we could all be in our own small way, right?

We know people are largely ignorant about diabetes so if we extend a little bit of accurate info everywhere we go we can do our part to help discourage all those myths and misconceptions out there.

What I was really excited to learn is that everyone I encountered was really eager to learn more about diabetes.  Even the 13 year old asked me, “Tell me about diabetes, I don’t know anything about it but I hear the word on the news all the time.”  They know it’s a big deal and many themselves are concerned about their own health.  Also, people are smarter than we give them credit for.

I found a great way to get diabetes in the conversation, too.  Just check blood sugar while sitting next to someone.  I only did it because I needed to but it sure worked to spark an interest in the subject.  And of course, instead of lick the blood off my finger I used a wipe.  Except for in the case of the 13 year old.  I did my usual routine and he thought it was pretty cool that I just “recycled the blood back in”.  Kids say the darnest things.

Travelling with Diabetes…and other Health Issues

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I haven’t travelled by plane too much in my life.  I’ve been to visit relatives in Venezuela, gone to Aruba with my pump (would have loved the Omnipod for that trip), went to Mexico for business and my honeymoon, and just this past week, Kansas City for A1c Champions training.

For this trip, I was so nervous about forgetting my insulin that I instead forgot my anxiety and allergy medications.  So not only did I not have my anxiety relief, I endured awful withdrawal symptoms like nausea, extreme anxiety, sweating, insomnia, and dizziness.  And since I didn’t have allergy relief, I got a sinus headache, sore throat, and swollen limph nodes.  Thank goodness the training and the people there were all splendid because without all that going well I would have cried the entire time.

Thanks to that anxiety I was having, my adrenaline sent my blood sugars skyrocketing.  Oh and plane rides seem to make my blood pressure drop, too.  I was almost sure I was going to pass out a few times and since I had forgotten my medic alert bracelet (another genius move), I had to write type 1 diabetes on my wrist with a permanent marker.  Geez, diabetes, how I’d love to leave you at home.

I’m better now and very equipped with information on how to not forget things when I travel again next month (aka, make a travel check list!)  Fingers crossed for a better travel experience.

Any tips for dealing with low blood pressure and motion sickness on planes?  I’m going to be travelling more and could really use some advice on what helps.  Asking the stewardess for a vomit bag does not make the poor soul next to me feel very comfortable.

By the way, if you’re curious about the A1c Champions program, it’s AMAZING.  Seriously, AMAZING.  You can learn more here: A1cChampions.com

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