Adieu, Animas

We knew it was coming, in all honesty.  When Animas Corp announced in October that their US operations were to close up shop and exit the insulin pump market, the elephant in the room no-one wanted to look directly in the eye was that the UK market operations would most likely follow. There were rumours, there were assumptions, and there was a shed load of speculation. Although insulin pump sales have been strong in the UK a global company like Johnson and Johnson has to look at the bigger picture.  And globally the Vibe pump market wasn't holding up.  As of this week, Animas have confirmed that they are to follow their US counterparts, and cease trading.  

My personal relationship with Animas has been a wonderful one.  I became involved with them by inadvertently inviting myself on their second sports weekend as the official blogger, before I had officially been asked.  They took it well and quietly confirmed I could go, but wen I arrived I was the only person who was noticeably overweight.  Horrified and convinced of the mistake I'd made, I toyed with the idea of slipping out early or feigning illness to avoid the mortifying embarrassment of being surrounded by an alien population of marathon-runners and semi-professional cyclists, but realised I had to do the job I was there to do.  After all, I'd invited myself - I could hardly back out now.  By the end of that weekend I had for the first time as an adult truly understood the power of being shoulder-to-shoulder with my diabetes brethren.

The next year I was invited back (officially, this time) and had used the tools from that weekend to lose almost 3 stone.  I was given the opportunity to share that journey with the attendees in a talk; my way of sharing with any other people there, worried about their weight or about being the odd-one-out, that they were not alone.  We are never truly alone, but somehow the sports weekend really hits that home.  Having a chance to share my struggles with my weight was a milestone moment for me, and it was Animas who gave me the space and platform to do that.

I decided to start using the Vibe when it was released, because as much as I liked my Medtronic and found their customer service superb, I was all kinds of done with kinky (not the fun kind) cannulas, and I wanted to get back in the water.  The Vibe was my partner in crime when I got back in the Cornish waves, and for the first time I realised the value of a waterproof pump.

I started running out of ways to say 'more awesome than awesome' as I was given the chance to return to the sports weekends year after year, so started to compile videos of Sports Weekend posts, because every year they exceed every expectation I could hold.

My Vibe travelled with me down under, and helped me traverse pregnancy, helping my daughter arrive safely in this world, a perfect little soul completely untouched by the constant change and mammoth challenge of a diabetic pregnancy.  Once again, Animas allowed me to share that by giving me the space to do so, because they seemed to 'get' what a scary time pregnancy can be, and that other uneasy wannabe mothers might just need to hear that it will be OK. It will be, by the way.

I'm going to miss them.  I'm going to miss them big.

Any time a medical tech company - particularly a giant like Animas - leaves the market it is a serious loss.  Losing any method of diabetes management (except for that lancing device which had the needle on the OUTSIDE! Because which idiot thought that would help us test more?!), means that people with diabetes have less options, and less options is a step backwards, no matter your taste in pump.

Oh, hell no.

I have enjoyed everything about my time with Animas, from meeting inspirational Heroes, to making lifelong friends at the sports events, to having a place to share my small but nonetheless shareable experiences. 

And I now have a mammoth task on my hands, because while I wasn't watching my pump warranty expired.  It expired a couple of weeks before Animas stopped taking new customers on.  It stopped a month before their formal letter notifying the world they were to stop trading.

I don't have a clue which pump I will try.  I don't even want to think about it right now.  I don't want to accept that my beloved Vibe has days which are numbered. It fucking sucks, if I'm honest.

The deal with Animas (UK)

I have not blogged since January this year.  In all honesty, I hadn't known whether my blogging would continue given that juggling household shift patterns around childcare, an abandoned allotment and a forgotten sewing hobby had all left me feeling as though I simply no longer had the words.  When I did log on to social media the arguments, snarky comments and age-old conversations seemed to be coming up.  It felt as though there was precious little 'new' to even deal with, and the 'old' left me feeling as though I'd already spoken about that and simply didn't want to keep repeating myself with so much else amiss in my world.  The DOC felt to me as though I was no longer a member. 

But then something changed which threw me back into the DOC at full force.

Two days ago, a friend posted on Facebook about Animas in the US and Canada 'closing down and leaving the insulin pump market'.  The article, seemingly from a reputable source and using all the correct language and knowledge of diabetes insulin pump supply, claimed this was happening with almost immediate effect in the US and Canada, and the rest of the world would follow.

What.  The.  Actual.

As a member of the Animas Heroes, and (devoted) Animas customer, I was shocked and so, so saddened to read this, but had also initially missed the bit about the rest of the world.  What do you mean, you are exiting the pump market, with my product?!

I emailed one of the marketing guys at Animas and asked what impact this would have on the UK.  Within an hour, a conference call was scheduled, and the cold facts were dawning on me. 

As I listened on the call to the horrible news, I realised just how much the world will miss Animas. How much I will miss Animas.  For me, they were the leaders in patient engagement, and where other companies only seemed to want to engage with the DOC when they have a product they want advertised, Animas seemed to want more.  They wanted to truly converse with their customers; they wanted to make a difference.

Animas made it clear that as far as the UK goes, it is business as usual; they will be in place for the foreseeable, due to the way in which businesses have to be closed in Europe.  There is no immediate commute over to a competitor, and new customers are still being taken on, but with an honest disclosure about what the future looks like.  While business has been successful in the UK, the picture worldwide has not been so, and in an incredibly competitive market, it simply came to an end.  Which sucks.  It really, really sucks.  The Sports Weekend is, of course, to still go ahead.  And as a J&J weekend as opposed to an Animas one, we hope there will be more.

I was always a little of an odd one out amongst the Heroes.  Some are champions in their sport, some have run unimagineable marathons, and some are insanely Grumpy (in all the best kind of ways).  I was the one who'd struggled with weight and through my journey using sports and exercise to try and tackle those issues, had also discovered deep-rooted issues with food and dieting.  But rather than end my contract there when things got complicated, Animas - and my family in the heroes - carried on just accepting that my daily challenge was just a different kind of challenge to the others. When the end comes, and end it shall, I will leave knowing I was on the team with a group of people, a company, even, who had all their priorities in the right place. 

Any time a treatment option is taken off the table it is a sad day.  But for it to be a company as well-established and market-leading as Animas, is simply devastating.

I will miss those people sorely.

It's sad that words came back to me because something so dear was being taken away.  And yet the last two days the DOC, for me, has been a different place.  It has been a place were people are asking for advice, answers, and support. What a shame that Animas had to be the catalyst for my DOC of old to return.

How do you feel about the news that Animas will eventually close up shop?

ASW2K16 video!

I've posted over and over about the value of knowledge and peer support the Animas Sports Weekend brings and this year was no exception.  As I drove home from the meet in October, the sky blackening as the early autumn nights I so love creeping in, I wondered if the other drivers on the M whateveritwas had enjoyed a weekend as wonderful as mine.

 

Just take a look for yourselves...

 

And don't forget to check out what Sir Steven Redgrave shared when I asked him about the value of Dr Ian Gallen's work.
 

 

The Airport Security pat-down/throw-down/interrogation experience

I love to travel.  And although I find aeroplanes claustrophobic on account of my control-freak tendencies and there being 300 people on board, I find air travel exciting, terrifying and amazing in equal measure.  What I find less enjoyable is the veritable lottery of what kind of  frisk, detention, terror-threat suspect, 'experience' I will have at the passenger security check thanks to the diabetes paraphernalia I cart around in hand luggage.  Bizarrely enough when travelling with a pump six years ago, I rarely encountered problems.  I made it to Thailand and back to a friend's wedding on my first ever with-pump journey, without incident.  A usual 'show it, explain it, politely decline to have it x-rayed' mantra was enough to make it on board without an MI5 security team interview.  In recent years however, this has changed.

At Heathrow in July this year, a well-meaning-but-having-none-of-it security guard insisted repeatedly that, "Even pacemakers are fine in the full body scanner".  His persistent claims got louder and louder and more animated until it felt like there were exclamation points at the end of every sentence. It gets hard to be polite when someone wants to disappear with your pump after refusing to accept that it couldn't be scanned.  After losing sight of my pump he returned with it and confirmed, once again, that pacemakers can go through it.  I will of course bear this in mind - if I ever get a pacemaker. 

My journey home from Frankfurt involved three women taking me into a 'detailed check' (kit off, sans dignity) while they appeared confused, befuddled, horrified by my CGM sensor.  This was followed up by someone shouting 'random bag-check' as they carefully selected my bag from the conveyor belt, at 'random'.

The Dubai chapter of the book was inexplicable. Voices were raised, arms were waived and scowls were given.  None of the above perpetrated by myself.

Somehow I made it to America, post 9/11, with 42 hypodermic needles and enough insulin on board to hygienically murder and entire crew while my friend got stopped for a corkscrew, and yet an insulin pump and CGM sensor bemuses most security staff. And I know that one of these days as it is whisked away from my view (against my requests) it will be put through an x-ray machine.

I understand it, of course.  Only 7% of people with T1 diabetes use an insulin pump, and there are currently at least five separate types of pump on the market right now.  There are hundreds of other pieces of diabetes equipment alone and there are God knows how many for every other condition which get seen daily as the thousands of people come and go from the country - millions worldwide.  With terror technology modernising as fast as - if not faster - than medical technology, I can understand why a safety first approach is necessary.  And I'm glad they raise concerns, frankly, because I can feel safe in the knowledge that when someone comes through with a device which on closer inspection is suspicious, I know they won't be on my flight. 

But the question has to be asked, if medical technology of any kind does come through airport security on a daily basis, why is there not a single policy which is part of regular, standardised training?  And why is it not worldwide, in the same way that airport security is standardised worldwide? Yes, there are hundreds of medical devices out there, but when pump companies and hospitals produce letters about the handling of these items, why are their hosts under fire of multiple questions, in different ways, dependent on the day of the week it is, and who is on shift that day?

The issues are that the damage - or possible damage - done by the full body scanners to an insulin pump - which is effectively a small computer - is largely unknown.  I have watched a fellow blogger go into one wearing their pump without incident.  But the warnings are clear, and are agreed upon by all the major insulin pump companies (Omnipod is not affected).  Going through any surveillance procedure which uses this technology with a pump carries a risk.  But as it becomes more commonplace to use full body scanners as the go-to security measure in airports, this places people with diabetes using technologies which are growing in popularity in a difficult position: refuse and raise questions of your suitability to travel, or go through and risk your pump being exposed to potentially damaging x-rays. Just how global can your pump company deliver a replacement pump?

The good news is that change is afoot, with your help.  This topic was recently raised at the Animas Hero meeting a group I have the honour of being part of, as a number of people raised concerns over the mandatory introduction of full-body scanners at UK airports from December 2016.  The following conversations uncovered that Rachel Humphrey at the Universal Freight Organisation was working to raise the profile of this issue at an international level.  Rachel is in contact with the Head of Training at Airports Council International (ACI), who are in turn going to raise this issue in May 2017 at the ICAO (The UN agency for Aviation).  ACI have said:

“The information has been forwarded to ICAO (The UN Agency for Aviation) for their consideration and advice on the best way to raise the issue globally to screening authorities."

ACI will present the issue to the ICAO Aviation Security Panel in May, requesting that it is included in global guidance material. Additionally, ACI will continue to raise awareness with its members through its committees and circulars to airports."

Although many people travel daily without incident, many are also subjected to arguments, questioning and the process of having pumps removed and taken out of sight, due to the varying degrees of training as to how to approach the issue of unfamiliar (should be familiar) medical technology encountered at airports.  I have a 100% record for botched security procedures inn 2016, and as someone who can hold my own but gets deep uncomfortable at the through of being one of 'those' passengers, it's clear this isn't just a one-off situation. And for those using technology which is becoming more common place year-on-year, this has to change. 

If this issue is important to you or someone you love or care for, please visit the links below and look in particular at the petition linked in. And if in doubt, contact your pump/CGM maker for a copy of their letter explaining how their device should be handled.

The official position of Diabetes UK on airport travel with diabetes can be found here.

The petition for a standardised approach can be found here.

The current protocol for security when travelling from the UK can be found here.

Animas Sports Weekend 2016: Part Two

This May just gone I had a little too much going on to manage to make it to the Animas Sports Weekend.  So this October, when the new-format weekend takes place on 8th and 9th October at Loughborough University, I will be there with bells on.

 

The weekend has been going around five years now and continues to draw people in time and again. Those who are there for the first time build friendships that last a lifetime. Those who have been before, want to go again.

 

Sports Advice

 

Exercising with type 1, particularly for those unfamiliar with exercise or those doing exercise which pushes them to new levels, is a tricky business.  Hypos, hypers, aerobic, anaerobic, diet, muscle repair, insulin dosing: the whole shebang can baffle my brain.  I've been on a number of occasions thanks to the relationship I have had the joy of developing with Animas but every time I go, I pick up something new.  Each time the knowledge and research by people like Dr Ian Gallen (who helped Sir Steven Redgrave reach his five gold medals at the Olympics) and Dr Alistair Lumb, deepens and broadens, so even if you've been before, there is more to learn.

 

Peer to Peer Time

 

Undoubtedly one of the highlights for me in going to the weekend is the joy of mixing with other people with type 1.  Learning from them, laughing with them, synchronising hypos; every bit of it is a joy.

 

Very few events in the type 1 calendar give the opportunity to mix with so many people living the same condition, so this weekend is socialising gold. It literally leaves you with the warm and fuzzies and 'fills you up' for months more living with diabetes.

 

Inspiration

 

Ever heard of people like Roddy Riddle, the type 1 Scotsman who made the 150 mile Marathon De Sables his bitch?  Or Claire Duncan who takes on ocean swimming or coast-to-coast in one day cycles (this woman eats marathons for breakfast)?  The team of speakers that Animas puts together could inspire a nation to get on their bike and give it a go.  And best of all, they are ridiculously wonderful people to spend a weekend with.

 

Alcohol

 

Because, there's a bar, obviously (hic).

 

How to get registered

 

Whether you are new to exercise, struggling to manage blood sugars in your normal exercise routine or stepping up to the plate for that marathon you always wanted to do, this weekend is for you.  The exercises are adaptable for those just wanting to try them out and for those wanting a challenge.

 

Registration for the weekend starts on the 1st August, when the link on this page will go live.  Spaces fill quickly so don't sit on the fence - hurdle it and give it a go.

 

Want to know more?  Then I guess you'll just have to come and see for yourself.

 

See you on the 8th October!!

 

Pregnancy and diabetes weeks 13 - 24: Trimester two

When I first fell pregnant it felt as though the magic 12-week mark, when we could more 'safely' announce to the world that we were expecting, was light-years away.  Managing my secret 'pregnancy diabetes' around colleagues and friends was tricky, but strangely exciting, like an affair with none of the sordid details.  By day I carried on in my job, exercise routine and social circle as usual.  By night I would sneak away to hospital appointments to discuss growing babies, bellies and basal rates. Bat-Anna and her new double life were in full swing.

But with the 12 week mark now upon us, we got to announce to the world that we two were to become three, and that the extra tummy 'pooch' (attractive, much?) and enormous(er) cahunas I was lugging around with me came with purpose.  We got to see our little growing bun, now less kidney-bean shaped and looking just like a little person, and were re-assured that we had passed the first round of testing for congenital birth defects.  At this point some of the many clinicians I was seeing would tell me I could stop taking my increased (5mg prescription strength) dose of folic acid.  Some however told me to carry on for a while, so I did, right until 20 weeks.

During the whole pregnancy the first three weeks of the second trimester on the sail into the unknown were the most easy-going.  Insulin sensitivity drifted off, giving a well-earned rest from the 45 minute hypos brought on by the final days of the first trimester, and now knowing there was a healthy kicking baby on board, life seemed to go back to normal.  My new normal, anyway. At about 12 weeks the placenta starts to function for itself, and the change in not only symptoms of pregnancy like spontaneous day-sleeping and ravenous carb-mania, but also the more predictable blood sugars, made for a veritable day off.

At the point we started to tell people was the first time I really started to feel pregnant, seeing as bat-shit crazy blood sugars are often all in a day's work for us D-champions, so even though I knew the hypo marathons were baby-related I had to repeatedly remind myself that's why.  But at week 15 the first flutters started to happen and my growing waistline and pride in becoming a parent was matched  only by the growing insulin resistance which started to hit me at around week 18.

By week 20 I was raising my insulin at certain times of day (between 2am and 5am) three to four times weekly, as my dawn phenomenon (when I am already most resistant to insulin) went into overdrive.  I would often have to notch up my overnight rates every 2-3 days, trying my best to leave a day in between to monitor my efforts.  FYI, if you can resist upping them daily you deserve a medal - one I will personally craft for you, but its worth it when you don't have to deal with monster hypos from over correction.  It was around this time that I truly saw the value of my Animas Vibe pump and Dexcom CGM into their own, because despite being 4.5 months pregnant not once had I had to wake my self up at night to try basal testing (the world's most futile during-pregnancy task) because my beloved Dexcom was all over that shit.  

Yayyyyy, my blood sugar today is perf.....oh. Ok

It was around this time of pregnancy that I also learned to make peace with the odd highs and lows. While traveling with my baby-daddy in New Zealand I had worn out the asphalt in many a campsite by walking at un-Godly hours through the guilt that a blood sugar of 12 or 13 mmol would give me in the pit of my stomach.  But the 20 week 'anomoly scan' had shown me that my body and overall

good control had so far given me a healthy, perfect baby, untouched by the blasted condition I carried around with me.  Some days I nailed blood sugars and insulin resistance, others I 'failed' miserably (or so I felt).  Some days were a bizarre mix of good and bad.  But every day was a day on the countdown.  I earned to tell myself that every day - be it good or bad - was a day I nailed.  And if I wasn't aware of my hard work paying off in the steady HbA1c and healthy scans I was pulling in, then the first true 'kicks' my kid gave me at 22 weeks, were all the sign I needed, because my kid clearly had something to say on the matter.

The second trimester was tough, in ways completely different to those in trimester one.  Instead of  being pro-active in my preparation for pregnancy, keeping secrets, dealing with insulin sensitivity and hoping to reach that 12 week mark safely, I had to learn how to be reactive, flexible, self-forgiving and most of all, to enjoy it.  Any time I needed a reminder of why I was trying so hard in my day-to-day life I just looked at those moving images of Baby McP, and any crappy day was forgiven.

I was now two thirds of the way through baking my bun and my daily mantra of 'test-change-review-repeat' felt a little like an annoying 2013 rave song, but kept me sane when the words 'routine' became a thing of the past, now replaced with 'constant change'.  The second tri certainly did a superb job of keeping me on my toes, but my new normal was somehow, working out just fine, one day at a time.

Insulin pump end of days: The Animas 2020, IR 1200 and IR 1250

With all the hype around the Vibe insulin pump in recent years it would be easy to forget about the the Animas 2020 insulin pump, which was a complete favourite across the diabetes community and at one time the most exciting pump on the technology landscape.  Many still wear one because they love it so much.  But for those people still using an Animas 2020 insulin pump (and the IR 1250 and IR1200) this New Year's Eve will signal the close of a chapter on their current insulin pump choice, because the software these pumps uses will no longer be functioning after 31st December 2015.

This has come about because of memory limitations of the technology at the time the platform was created, but as these products are no longer manufactured by Animas they are focusing their efforts on creating the next generation of products in order to provide patients with better solutions and sheckshy new technology.

After 31st December 2015 the pump will no longer function, and will generate a 'Call Service' alarm.

In order to avoid any disruption to insulin pump usage, it is really important that you contact Animas UK as soon as possible, who will offer a replacement Vibe pump, if eligible.  No additional warranty will come with the new pump.

If you use a 2020, IR 1250 or IR 1200 please contact Animas on:

Customer Service

0800 055 6606 (for UK)

1800 812 715 (for IE)

A belated look back at the Animas weekend 2015

Somehow life has run away with me in recent weeks, but finding time to review the Animas weekend which took place back at Loughbourough University in May 2015 and give a little look at the photos from the weekend has been a 'must-do' for quite some time.  

Two years ago Sir Steve Redgrave said this about the journey he had been on since meeting Dr Ian Gallen after his diabetes diagnosis, and then going on to win his fifth Olympic Gold medal after his guidance and advice:

When I was diagnosed with diabetes and thought that my sporting career would have to come to an end I was absolutely devastated.  But with the support of Ian Gallen and his team, I was given the confidence to carry on with rowing and I was able to stay at the same level that I was at before having the condition; going on to win gold at the Sydney Olympics 2000.  I came up with the quote "diabetes has to live with me not me live with diabetes."  And that has stayed with me ever since in whatever I do in life. 
Steve

Want to find out more information for next year, so you can come along and be immersed in a weekend of fun, surrounded by people with type 1 all wanting to learn more about sport and the effect it has on diabetes, then email sportsday@its.jnj.com.

And check out the video montage of this year's exploits.

Enjoy!

Loans without interest

If Charlie has one cannula which lasts two days, a bottle of insulin which lasts 10 and a bottle of 50 test strips, how quickly will Charlie travel 15 miles on a train travelling at 60 miles per hour?

I finally understand the point of those seemingly inane classroom maths quizzes.

As we plan for the big trip, and the possibility of Armageddon, my brain turns to mush at the mind-melting mathematics I have to do in order to make sure I have all the equipment, insulin and general diabetes paraphernalia I am going to need to successfully navigate my way across the other side of the world for just two short months.  As I do so, it reminds me how vital each link in the diabetes armour I wear really is: without cannulas, the tubing is pointless; without tubing, the insulin is redundant; without the insulin, I can expect only to get to know the hospitals of New Zealand. If any one piece of this equipment fails, the rest is rendered obsolete.

But above all, none of the equipment has any use at all if my pump pops its little Animas-shaped clogs while down under.  Animas, like many pump companies, offer a loan pump service if you are going away for a while.  As I ticked the final boxes on my checklist of travelling to-dos, I called them up and ordered my loan pump.  I'd already ordered my pump insurance (mainly because loan pumps are covered on this ample policy), but on the off-chance that something should happen, I wanted to make sure I could just switch pumps and carry on enjoying the trip of a lifetime.

Once again Animas' customer service impressed me when they agreed to let me use a loan pump for two months, as opposed to the couple of weeks they normally offer one.  They did have to check this amount of time would be OK, and carried and a couple of checks to make sure their stocks were high enough to ensure other customers could also use a loan pump if needing to, but my spare pump, in New Zealand pink (other countries are available), arrived today, shiny and boxed up ready to go on a journey of its own.

It is worth remembering if you are going away to check that your pump company does offer this kind of service, and that an extended trip won't be a problem.  I'm also taking pens, insulin and needles with me just in case, but having this little safety-net on board while I'm away makes me feel even more safe while honeymooning in an unfamiliar land.  Thank you, Animas.

Animas Vibe, Stateside

After four happy years on the Medtonic Veo insulin pump, I made the decision to switch to the Animas Vibe in January this year, after careful consideration.  I've always known that the customer service behind a pump is far more important than its sexiness, but having got to know the pump, and experienced some of the customer service, it was, as they say, a 'no-brainer'.  

I've been rocking Dexcom CGM as part of my diabetes arsenal for almost two years, without a single day when I've taken for granted this incredible technology.  Integrated CGM means the option of  the glucose data being sent straight to the colour screen on the pump, rather than lugging around a

separate unit with the already weighty collection of diabetes paraphernalia I keep at my side constantly.  And the waterproof feature meant I could start surfing again without the blood sugars creeping up to the uncomfortable teens afterwards.  A day-kayak no longer comes without the unnerving feeling that too much fun could end in tears.

Our friends in the US have long been waiting for the Animas Vibe to reach their shores, thanks to the FDA's notorious much lengthier and more stringent approval process.  But there's great news........The Vibe is Stateside!

In a press release from earlier today, Animas proudly announced the release of the Vibe in the US, now approved for people aged 18 and over. So those over the pond an finally get their hands on this sexy little pump, from a company with an excellent rep.

Check out their website for more information, here.

Down Under with D: Travelling with diabetes

When we tied the knot three years ago and took a brief 4-day trip to Cornwall as a 'mini-moon', Jamie and I could never have known how much would change almost instantly in our financial situation.  The plan had always been to travel New Zealand for our honeymoon, a dream I'd had for the best part of 10 years.  But with the recession, a property which plummeted in value and a redundancy for Jamie things took a turn for the worse, and the honeymoon we had planned had to be shelved until further notice.

Three years on, and with a lot of hard work and saving under out belts, Jamie and I are finally realising that dream and in just under two months time will travel down under to spend nine weeks in New Zealand and Australia, finally enjoying the honeymoon we never had.  We've spent months booking flights, researching the best ways to get around, studying travel guides, investing in snazzy cameras and checking out the delights that these magnificent countries have to offer.  But as the time to head off to try our hands at being intrepid explorers approaches, the daunting task of travelling with diabetes has started to dawn on us.

At times travelling with diabetes can seem like having an extra person to manage, from catering for the extra bag the insulin pump and CGM paraphernalia demands, to the pre-ordering of 3 months worth of supplies, ensuring we have a plan for hypo treatments to keep on us at all times, and locating hospitals and places of safety abroad, just in case anything goes wrong.  And I've learnt that if you plan for Armageddon, you will be somewhere close enough to being prepared for the adventure ahead.

Here are a few of the tips I've learnt:

Flying 

We've chosen to fly with Emirates, and discovered the benefit of being able to reserve exit row seats, - albeit ones we may have to give up if anyone is travelling with a baby.  Now, exit row seats aren't a diabetes issue as such, but as someone who has found that my blood sugars start to rise as soon as I start to get uncomfortable or frustrated on long distance journeys, having the option of being a little more comfortable and being able to get more sleep - therefore reducing the levels of adrenaline and cortisol flying around my system disrupting my blood sugars - is a god send.  Our journey is an eye-watering 27 hours, so the more of that I can avoid my blood sugars going haywire, the better.

Disconnecting during take-off and landing

When I read this article by Melissa Lee at A Sweet Life about why to disconnect your pump during take-off and landing, I was flabbergasted that more is not made of this in initial pump-user training.  You see, when the pressure changes inside the plane, your insulin has no way to cater for those pressure changes without pushing air out of the insulin, called 'outgassing'.  Think of a can of fizzy drink, when the pressure in the can changes by you opening it, air bubbles are forced out of the liquid.  The same thing is happening with your insulin as it forces a bubble out of the tubing in order to cater for the pressure change.  That bubble is now sitting under your skin, causing your blood sugars to rise.  Then, when pressure decreases again suddenly, the bubbles gathered in the tubing can be pushed back along tubing forcing insulin into the body, leading to what they call 'Baggage Claim lows'.  And your pump will be none the wiser.

The easiest and best ways to cater for this are to disconnect your pump on take off, and priming and re-connecting once the plane is above 20,000 feet and levelling out, because it is better to be absent of insulin for 30 minutes than for those bubbles to make their way down your tubing leaving you with 2 units of air at the end of it.  And when the plane starts to descend, do exactly the same, to avoid any bubbles lodged in the tubing pushing insulin back out again.  Voila!

Keeping Insulin Cool

Insulin is only guaranteed to be 'stable' for 28 days when out of a refrigerated state.  After that time it may well still be OK to risk on a personal use basis, but if you are using a three-month old supply and it doesn't seem to be touching the sides anymore, this could well be the reason.  I've only ever been away for 2 weeks before, so this is the first time I've had to consider how to keep my insulin supply cool for the second month - particularly as we are primarily camping and using hostels in major cities.  I use between 50 and 70 units a day, so am catering for 1 ml a day, just to be safe.  That means I will use a 10 ml vial every 10 days.  We are there for a total of 65 days and I will take 2 spare bottles.  You know, in case of Armageddon.  That means I need to take 8 x 10 ml vials with me.  Three of those I can keep out, because I will be using them in the first 28 days, but the other five I need to keep cool while not in use.  But how, when rocking campsite chic in the deepest darkest 'nowhere' in New Zealand?

Frio have an ingenious cooling bag designed for exactly this little conundrum.  The bags are effectively like little picnic cases, and can keep insulin cool for up to 45 hours by immersing the pack in cold water for as little as 5 minutes (depending on pack size).  So every couple of days you can dunk and go, keeping your unused insulin cool for that time.  Perfect!

Loan Pump

My pump quite literally keeps me alive.  It is my most precious possession, even more that my beloved phone or laptop.  But it's also just a gadget: a gadget which breaks. If you use insulin pens with background insulin, then you have a good 24 hours before you would be in a situation of dire medical need.  With a pump, the moment I pass the three hour mark after I unhooked, my body is without insulin and my blood sugars are already starting to rise.  Being without my pump is not an option, and although I am taking pens, syringes and insulin bottles in case the worst should happen, my preferred method of insulin delivery is my pump. If nothing else then to enjoy the trip without doing battle with my bloods sugars, or sitting out of activities because I feel ill.

Most, if not all, pump companies now offer loan pumps, which is a spare working pump you can take away on holiday with you at no cost.  Before you go, take a photo of your current pump settings, so that you could programme a new one and bam!, you're covered.

Just contact your insulin pump company a few weeks before you go and ask for a loan pump.  Any company worth its salt will have you one in the post within days.

Knowing what's around you

Although I haven't needed a hospital trip for my diabetes in the last 20 years, it's a good idea never to get cocky with diabetes.  Only two years ago I found myself on the kitchen floor hallucinating about people being in the house as Jamie called an ambulance, because I was terrified and suffering too aggressive convulsions for him to get the emergency glucagon into me.  One little repeat of that, and our trip could be cut horribly short with an emergency hospital stay. 

I discovered an app called 'Camper Mate' which is a smart phone app showing you at a glance what is near you in NZ, from petrol stations to free camp grounds, or hospitals. If anything was to go wrong - if we lost my medical supplies or had them stolen by a wily Hobbit; if I was fighting an infection and blood sugars were uncontrollably high, whatever, this app will help me locate nearby hospitals and doctors, and help me feel safe whilst making memories of a lifetime.

Insurance

The person with diabetes who goes away to an unfamiliar country without medical insurance, is a fool.  In Europe we have the benefit of the EHIC card, which can get you free medical care at the point of access, but this doesn't work once outside the borders of Europe.  But medical insurance, once you disclose type 1 diabetes, can go from 'pricey' to 'cancel the trip' status.  I'd always heard that Diabetes UK offered affordable insurance, so called them up for a quote.  Much to my horror their Gold Standard package was a jaw-dropping £456!  Sinking to their bronze cover was still going to cost me £318, and now came with a higher £70 excess and dropped personal belongings cover to well under £2000, although medical was still £10,000,000.

On the advice of fellow PWDs, I dropped by Insure and Go, and was astounded when they offered me £10,000,000 medical, £2500 personal belongings cover and only £75 excess, for £156.  That included 15 days worth of 'hazardous activities' and full coverage of my type 1 diabetes.  And did I mention that covers Jamie and his working pancreas, too? It's a no brainer!

Insulin Pump insurance

Until recently it hadn't occurred to me to get my pump insured, because as I wear it 24/7 and any problems I've had in the past have been mechanical or damage covered under warranty, the pump companies I've used so far have switched them out within 24 hours.  But on this trip I'll be taking a loan pump, and although my pump is waterproof I may make the decision to remove it during any activities where it could risk being damaged.  That means if anything were to happen to either my own pump, or the loan pump, I would have to pay for a new pump.  And they are a complete steal at £4,000 each! As I rely on it, quite literally, to keep me alive, I didn't think the £6.99 policy with Insurance 4 Insulin Pumps was all that bad - especially as they cover loan pumps and worldwide travel.  Some home insurance policies will cover your own pump, but as someone without my own home insurance, and with a loan pump to care about, this was yet another obvious choice.

And finally...

Continuous Glucose Monitoring with the Vibe

I have been a fan of Dexcom CGM since before I started using it, and deeply in love with it since I first hooked up.  I also use a Vibe insulin pump, and although I had to step away from integrated CGM recently due to one too many overnight hypos waking me up with the pump vibrating violently at my hip, I don't want to take any extra equipment than I need to.  The idea of this trip is to 'scale down and live it up'.  So for the two months I will be away I plan to integrate CGM into my pump, so that I have one less thing to carry.  And as the handheld unit costs around £975 in the UK, I think I can deal with the CGM alarms buzzing away at me for just a little while.

Life with type 1 diabetes is about finding a balance between planning, reacting, damage-control and the odd 'hands in the air' moment of confusion.  But the purpose of all this is that when Jamie and I take that honeymoon we've always dreamt of, and will tell our children about, we can say we enjoyed every second.  The planning is so that when faced with these views, diabetes fades away and experience takes over.

Animas Sports Weekend 2015: Registration has opened!

It's that time again, when people with diabetes across the country dive for their laptops to get their registration request in for one of the biggest weekends in the diabetes calendar in the UK.  It's the Animas Sports Weekend 2015!  

The weekend is an opportunity for people with a love of sports, or those wanting to know how to manage the diabetes beast in order to try it out.  The first year I went, I hadn't exercised property in years.  The last time I exercised was two days ago, and my blood sugars stayed between 4.5 mmol and 6.7 mmol throughout my hour-long session. That's on the Animas and Dr Gallen team, having given me the tools knowledge and confidence to exercise property.

Whether you just want to be able to take a gentle stroll with the kids, or want to run an ultra-marathon, this weekend will give you the tools to start on your way. It is run by Animas (but open to people on all manners of treatment) and headed up by Dr Ian Gallen, who helped Sir Steven Redgrave train for the Olympics after being diagnosed during this run of Gold-medal achieving accomplishments.   Sir Steven was kind enough to give Insulin Independent this glowing review of the work Dr Gallen does:

"When I was diagnosed with diabetes and thought that my sporting career would have to

come to an end I was absolutely devastated.  But with the support of Ian Gallen and his team, I was given the confidence to carry on with rowing and I was able to stay at the same level that I was at before having the condition; going on to win gold at the Sydney Olympics 2000.  I came up with the quote "diabetes has to live with me not me live with diabetes."  And that has stayed with me ever since in whatever I do in life."

Added to this already impressive set-up for a weekend, the event also offers the opportunity to meet and have an amazing time with other people with diabetes. That, in itself, is reason enough to go.  Often I hear people say they want to get fit before the weekend starts, because they are put off by the sounds of the activities.  But the weekend goes at your own pace, is full of people with completely varied levels of fitness, and is solely for the purpose of learning.  And as the fun from the activities subsides, the laughter moves to the lobby where there are guaranteed to be a troop of people propping up the bar into the early hours as they swap comical hypo stories, put diabetes to rights and form bonds that will last year after year.

So, I look forward to seeing you there! Just email sportsday@its.jnj.com to register your interest

CGM: A happy distance

Since the first time I inserted a Dexcom sensor and saw my 5-minutes-apart glucose readings flash up on the screen in front of me in real time, I have never looked back. It was a commitment, deciding to self-fund the arguably expensive tool to manage my blood sugars, but a sacrifice it was not.  My choice to use CGM wasn't about the SafetyNet it provides, although that is a selling point in itself. Instead, it filled in the frustrating gaps I experienced when trying to gain better control.  

Going all non-integrated, again.

But last night, as I pulled myself firmly into the back of my peaceful sleeping husband, matching my shape with his, and trying to improve the already bad night's sleep I was having, my Animas Vibe, now having my CGM readings integrated into it on an almost permanent basis thanks to the convenience that brings, started to violently vibrate in the small of his back.  He awoke with a fright, and patient soul as he is simply asked, "Are you OK?"   It was the third hypo of the night, and it was the third night like this in a row. As tired as I was of treating hypos, I'm sure his tiredness was greater still.  He didn't even need to be awake.  A safety-net it is, but a sleepless night and being awoken by the endless buzzing beeping and frightful noises of the Vibe were enough for me.  I treated my hypo - a slight dip below 4.4 mmol - and turned my CGM function off, leaving the redundant but brand-new sensor in my arm. 

This morning I decided to switch back to my handheld receiver.  The downside being that I have to carry yet another device with me.  But the benefit being I don't have to keep it attached to myself, or my long-suffering husband, for a little while.  I quite often don't hear the initial beep or vibrate of a first hypo warning.  And quite often, my blood sugars are simply nudging above and below the alarm line.  That way, a slight drop in blood sugars which was always going to correct itself doesn't need to be the frustrating interruption it sometimes needs to be.  And my husband can sleep easy.

And sometimes, we just need a break from it all.

European Blogger's Summit: how YOU can get involved!

Last year I was lucky enough to able to attend the European Blogger's Summit in Barcelona because of the work Insulin Independent has done with Animas (hosting the event) over the past 3 years. It was an insightful and informative experience with fascinating information on how to increase traffic to blogs, but as a group the overwhelming feedback was that we wanted to really open up a dialogue with each other about the local challenges faced by our respective communities; communities which once a year are stripped of their geographical boundaries and amalgamated into one truly global community. This year, Animas gave us a day, several pots of coffee and a place to talk: the rest came down to us.

What became overwhelmingly clear as we came together and began to talk about the challenges was that while we often face many of the same general hurdles - like access to medical technology, political battle or stigma - the ways in which those challenges play out locally, can be very diverse.  The purpose of this meeting was to share our experiences with each other and this year the question which repeatedly raised its head as each blogger took to the presentation stage was this: is there a way you can help us?

But as diverse as the group of people who came together were, we are by no means a true representation of the diabetes community.  We are just a few faces of a community whose reach expands across the world.  So rather than just give you a run-down of the topics we covered, this post is about how YOU could also get involved. 

Spare a Rose

First up Kerri Sparling talked about the Spare A Rose campaign which took the online communities by storm earlier this year.  The idea behind the campaign - started by Partnering 4 Diabetes Change (P4DC) and supporting the International Diabetes Federations's (IDF) Life for a Child movement - is that during the highly commercialised event of Valentine's Day, rather than buying a loved one a dozen red roses, instead give the 11 roses, and give the equivalent cost of one red rose (around $5) to the Spare a Rose campaign, which, through the IDF, provides insulin ad education to developing countries where not only is insulin desperately hard to come by, it can keep a child alive for a month - just for the cost of one red rose which may wilt and die within days.  Spare a Rose started in America in 2013 and raised an impressive $3,000 in its first wave.  But by Valentine's day 2014, it had raised over $24,000, involved more than 24 countries and reached around 8 million people via social media attention.  Just imagine what it could do in 2015?  So if you tweet, blog, give to charity or feel passionately about the situation in impoverished countries and realise how lucky we are to have a butter compartment stocked full of life-giving insulin, then please give whatever exposure (or donation) you can to #SpareARose.  

#ShowMeYouDiabetes

From Italy we learned from Biagio Barletta that they had been working tirelessly on a campaign to educate and awareness raise about life with diabetes, using Twitter as a platform for change.  On the back of the incredible #ShowMeYourPump campaign started by Miss United States of America hopeful Sierra Sandison (Idaho) which took the world by storm during the Summer of 2014 and saw people 'outing' their pumps in a bid to break taboo, Italy are going one step further.  They ask that every day you post a picture on Twitter of YOUR life with diabetes; what it means to you.  Do you use a pump?  Can you share a fact?  Do you want people to know what a blood test looks like?  Then do it, using #ShowMeYourDiabetes.  Make the world see what diabetes really is.  

Parliamentarians for Diabetes Global Network

Renza Scibilia, representing Diabetes Australia as well as her blog, Diabetogenic, talked about Parliamentarians for Diabetes Global Network - an advocacy programme established by the International Diabetes Federation (IDF) in December 2013.  Renza asked bloggers to highlight this Network of parliamentarians who established eight global aims which, amongst others, include eliminating stigma towards people with diabetes, encouraging governments to make active efforts to meet targets set by the World Health Assembly, to provide a platform for dialogue and to work towards urgent action.  How can you do this?  Through the power of your local Member of Parliament.  By linking with them and highlighting the urgency, need and global importance of this network, we can show them why the PGDN is a commitment they can, and should, make.  The Network is only open to parliamentarians so the power is within our hands to bring this powerful and potentially influential network onto the radar of parliamentarians. 

Bringing community for people with to Germany

Ilka and Finn from Mein Diabetes Blog, and Tine from I Can Eat Everything were taking part on behalf of the fast-growing influential German diabetes community, and Ilka presented about the lack of events and come-together occasions for people with type 1 in Germany, and the isolation she felt on walking into an event for diabetes, and being the only person with type 1.  Ilka demonstrated the power of the diabetes community when she approached sponsors to ask for  funding for a diabetes event specifically for people with type 1, and a few months later arranged an event attended by over 180 people from across the country. So if you want to get involved in more events for people with type 1, keep an eye on these  blogs.  Ilka also spoke about the changes going on at MySugr headquarters and new developments of the already wildly popular app.  They look like they could truly make waves in engaging even further with their communities, so keep your eyes peeled!

Adventure D, peer reviews and psychosocial support for people with diabetes

And finally representing the UK The Grumpy Pumper's Chis Aldred and The Understudy Pancreas' Annabel Astle told of their extensive work in the last year with Diabetes UK, JDRF and healthcare professionals in the NHS to help shape services and education.  In particular, Annabel spoke passionately about the Peer review processes she had been involved with to look at the diverse experiences of paediatric care and services in the UK.  

I presented about access - or lack thereof - to psychosocial support within diabetes clinics, and the way in which people experiencing any psychological challenges have no clear path with which to access services available within the  NHS.  This is a project with Ninjabetic's Laura Cleverly at the helm, and the project is so very in its fledgling form that I am not yet ready to share what the next steps are for us locally, but as was intended with these groups, we were already able to learn from the global communities around the table about how they had started these processes within their respective communities.  So watch this space! 

And finally, I told the group about the success of the Adventure D launch weekend (more on this, later).

As the summit drew to a close a list of actions were compiled and plans agreed as to how to move our respective projects on in the coming weeks and months.  

It's not often the  global diabetes 'online' community can come together to become  a global 'offline' community, but when it does, it is a powerful thing. And as the mandatory group shot was taken and the event came to an end, a promising future of global focus on local challenges was emerged.

Animas Sports Weekend 2014...

I've been talking about what an incredible experience the Animas Sports weekend is for two years in a row now, and you can find my rave reviews here, and here.  This year, I wanted to shake things up a little.

This weekend is one of the most looked-forward-to events in the diabetes calendar, and I'm running out of ways to say how great it is.

This year the talks were incredible, the people were inspirational and the weekend as ever, was one you don't want to miss.

Thank you to all the incredible people who let me have access to their photos, including all the twitter folks, Animas and Rachel, for letting me show you what the weekend is like through everyone else's eyes.

So check it out, here.

And for Triathlete Terrence Teixeira's top 3 tips from the weekend for understanding diabetes and sports, check out his video here.

New year. New pump.

An insulin pump becomes a part of you when you wear it every day.  It becomes your friend; your partner in crime; your invisible ally; and even your enemy at times. But it is a part of you, come what may. 

As this blog turns four years old on January the 24th, having been started the day before my pump journey began, the time has come for a new pump to be chosen. Pump warranty lasts for four years. And as this has proved such an effective self-care tool for me (with a million pointers from my long-suffering (but well paid) team, and lesser-paid members of the DOC) I have earned the right to keep this tool, according to UK standards.

The way I see it I have three viable options. 

My Paradigm Veo has been my lifeline for the last four years and I could not rate Medtronic, the company behind it, more highly. Their customer service is second-to-none, their technology superb and their customer engagement on the up all the time. But pumps have what the world likes to call,  'Unique Selling Points'. Much like a car, phone or long-desired gadget you may still be delighting in after Christmas, there will be something about each pump that best suits your life and your needs. 

When I started the Veo I still didn't fully understand the mechanics of Continous Glucose Monitoring (CGM), but I knew that Medtronic were the only company offering this in the UK, which is why I so wanted one; just to have that option. Patient choice.  The pump teamed with CGM has a low glucose suspend feature which, if you suffer from unexpected hypos - particularly overnight - is a godsend. 

But, travel a few years forward and having tried the Enlite CGM and come to learn about the Dexcom system which people seemed to so rave about, I fell in love with the Dexcom way of doing things. And this was the system I ultimately chose. Given that fact, perhaps the USP of the Veo isn't quite so relevant to me anymore? 

My second option was to go tubing free. You know those people who say the tubing is no big deal? Well, I. Am. Not. One. Tubing is the bain of my life and for me, the one part of pumping which pisses me off. Anyone with cats will understand  the kitty playground you become during set changes. Anyone with doorknobs in their houses beware, should even an inch of tubing escape from your waist area, be prepared to learn what 'involuntary tubing-induced reverse' feels like. 

The Omnipod is the only tubing-free patch pump system available in the UK, and since the upgrade to a newer, smaller pod, is freakin' tiny! It's about a third the size of normal pumps and can be place anywhere on the body you can inject, being controlled with a wireless remote-control. Sex. Ee. 

My experience with Omnipod all those years ago when they first landed on our shores was not good. I won't go into it again but they seem to have turned a corner. This time my demo pod arrived only days after my enquiry with a bright, bubbly letter. Their communication has been good and word on the street is their popularity is growing all the time. 

But I keep a close eye on their Facebook group, because I'm a nosey PWD who likes to know what's going on, and the frequent complaints about pod failures, some people claiming up to 10 month (seriously?!) is something I can't overlook. You see, the next pump I wear will, I hope, bring me through at least one safe pregnancy. I have been using steel cannulas for a year now because Teflon ones kink like a bitch, and switching to steel ones means I've removed that risk factor all together.  Omnipod don't have steel cannulas, a USP I have come to rely on. 

Perhaps that's why, despite its attraction and apparent popularity with Omnipod converts, I haven't even taken it out of the box. It still sits neatly in my (rapidly growing) diabetes drawer under the bed, still resting in its case. (By the way, anyone else's bedroom/kitchen/living room drawers being taken over by diabetes paraphernalia?!).

So I have one last option: the Vibe. The Animas Vibe is a tethered (meh) pump, but it has several features which - for me, for now, for my life -  make this one a major contender. Firstly, the Dexcom I so treasure can now be integrated onto the screen of the pump in exactly the same way that the Veo's could all those years ago. Granted, I have a (very expensive) handheld receiver that I prefer to use (easier during exercise/work meetings/dates/driving) but like those steel cannulas, I have come to rely on my Dex so much, and plan to make it a huge part of my diabetes management during pregnancy, that if anything were to happen to my handheld receiver I would be screwed. We can't afford another one, end of story. So as with the Veo all those years ago, if the worst were to happen and it broke/got stolen/ran away to Rio, I would have the back-up option of my pump which can act as a receiver and display the information to me. 

Secondly, my husband Jamie and I hooked up because of a surfing holiday to Cornwall. It was one of the fondest times of my life and for three years we went back every year to the same place, and beach, where we became a couple whose futures were intertwined. Problem was, with an insulin pump that was barely splash-proof, I had to go without insulin for the 4 or 5 hours we would be at the beach, and sure enough each time I would have angry tell-tale high BG readings for hours afterwards, making it an increasingly miserable experience. The Vibe, you see, is waterproof. Problem solved. We could surf again. I could Kayak without trying to squeeze my pump into waterproof cases that barely work and worry the whole time that splashes of water may render my pump useless. The Vibe, solves that problem. 

It also has steel cannulas. And a customizable food database ready for (*squeezes eyes shut and prays to a god she doesn't believe in*) a pregnancy. 

Have you lost count of the USPs yet? Yeah, me too.

The choice was obvious to me, too. 

I've been hooked up to my cutesy, pink, pumpette now for 48 hours. Unlike my initial learning curve of 'ohmhgodIpressedthewrongbuttonamIgoingtobreakit' when I first plugged in the Veo,  I have learned that the way a pump functions is pretty much the same from one pump to another. A bolus is a bolus; a temp basal is a temp basal. There are, I guess, some features that seem awkward to me because the vibe does them differently to the Veo. Mechanics are louder on the vibe but the screen is easier on the eye. Some menus are more complicated, some things are much easier to find. I know that familiarity will come with time. In a matter of weeks, maybe days, I will forget the 'old' pump and simply remember the new. 

So here she is, the still-nameless-but-rather-beautiful, bath-tubbing, Animas Vibe. 

And so the next leg of the journey begins. 

The mandatory Animas water action shot

Surfing with diabetes: Face-planting and packing the right kit.

When you start dating, you could choose to put on your best clothes, douse yourself in perfume and dine at the most expensive restaurant in town.  That, is a great way to get to know each other.  The other option of course is that you could, as Jamie and I did, drive to Cornwall, squeeze into a frighteningly tight wet-suit not designed for someone with a chocolate habit and throw yourselves repeatedly into the powerful battering waves of the North Atlantic Ocean.  While doing so, you will of course also face-plant the water over and over again with blind optimism, sheer determination and in an attempt to 'impress' the other.

We first caught the surfing bug when we stumbled across  Escape Surf School, back in 2007. Based under St Christopher's Inn Hostel, Newquay and overlooking Towan beach, it was a beautiful place to be for our first date.  On the first morning we immediately clicked with the instructors, Mike (pro-surfer, coach to the British Surf Team and possibly the most friendly man alive) and Will (awesome guy who's won countless competitions, coached the British Junior Surf Team and can even surf without a surfboard.  Show off.).

Wet-suit unfriendly
diabetes paraphernalia.  

Surfing is a challenging business: not in the least for a person with Type one diabetes. Let's put aside the issue of blood testing in the water (extreme aqua blood testing?) and think about where the hell you keep your glucose tabs, insulin, blood test meter and insulin pump when wearing, well, little more than a skin-tight neoprene wet-suit. Considering there is barely space for my ample rear-end, finding space for my diabetes paraphernalia is even more of a challenge.                   

                                                   

This September Jamie and I made our way back to Cornwall for our annual anniversary trip, and what better way to celebrate than to head back to our favourite surf school, catch some waves and work on our surfing style (see also: face-planting).  

Before heading into the water on day one my blood glucose was a fantastic 9.0 mmol: a great number pre-surf.  With a swig of Lucozade and the removal of my insulin pump, I surfed for the whole session with no problems, and as we got back to Escape's welcoming warm showers and Belushi's legendary burgers, I was rocking a perfect 10.0 (mmol).  It was a resounding success, by anyone's standards.  As was my face-pl...I mean, surfing.  My husband on the other hand, rocked it.

Jamie, who tells me that he is expecting O'Neill's call any day...

Day 2 however told a different story.  My pre-surf BG test revealed a 4.0 mmol and as 3.9 mmol is technically already a hypo, I devoured most of my first bottle of Lucozade before we'd even left for the beach.  I put the remainder of the bottle and my blood test kit into Escape's first aid bag, and headed in the direction of the waves. Why it didn't occur to me to take my second (full) bottle of Lucozade I will never know, but one hour in and after a monster wipe out, I felt the tell-tale signs of a hypo arrive.  I told Will I was heading in, enrolled the help of Jamie to babysit my board while I tried my hand at extreme aqua blood testing, and made for the beach.  Escape instructor Sarah had already spotted me wandering in, dragging my board behind me in a less than cool-looking way, and came to check things out. Calm but attentive, she jogged off to get my testing kit, like it was no big deal. There is nothing worse than a panicker when you are feeling hypo, so Sarah's chilled-out attitude was a breath of fresh air.   

Thank you to the photographer, for the photos...
...and the shorts!

Luckily for me the photographer, there to catch our most impressive surfing attempts (see also: watery face-plants), let me to dry my hands on his shorts because I forgot to pack any tissue to dry my fingers (worst prepared diabetic ever award?).  But then what better way is there to get to know someone than to wipe your salty, water-wrinkled hands all over their shorts?

As it dawned on me that my second bottle of Lucozade was at the top of the hill in the changing rooms, I prayed I was just tired from the surfing (see also: sea-bed face-planting). I watched nervously as the meter counted down.

5, 4, 3, 2, 1.

3.2 mmol.  

"Shit."

I looked back up at the hill I might need to climb, wishing that the last mouthful of Lucozade I just finished would be enough to raise my BGs.  I knew it wouldn't be.  

"Hey", I heard from over my shoulder.  "Here you go, have these."

As I turned around Sarah placed in my hand a full packet of glucose tablets and smiled. And just like that, her eyes were back on the surf watching the surfers get acquainted with the sea-bed (see also: beachy face-planting).

I let out a sigh of relief.  

It had never occurred to me that the surf school I learn with might need to be diabetes-savvy. I have always been fiercely independent in my management of diabetes, so other than the mandatory 'type one diabetes' on the medical form, I don't really demand the help of others, or expect them to be prepared.  But as I discovered this year sometimes, they need to be. Because even someone with 26 years of diabetes experience can mess it up sometimes.  

Wild dolphins, who swam amongst us for over an hour

My own complacency after just one successful surf could have brought me crashing to my knees and ruined a fantastic surf (see also: every kind of face-planting there is), but thankfully for me Escape Surf School were totally prepared.  Not just in the amount of instructors they have watching over our inexplicably comical efforts to walk on water, but also in the supplies they took to the beach and the speed at which they calmly dealt with my efforts to derail their lesson.

Escape, thank you. Not just for a weekend where I experienced wild dolphins playing in the harbour while we surfed, but also for being prepared for all eventualities: especially unprepared people with type 1 diabetes.

Can you guarantee the surf company you chose have supplies if you need them to?  I can tell you first hand that Escape do. 

See you next year! 

Me, apparently trying to kill Sarah