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I Heard the Rain There Stays Mainly on the Plain.

Tomorrow night, Chris and I are traveling to Spain to visit the set of his movie.  (Have I mentioned this?  ;)  Just in case I haven't, it's:  Buried, written by Chris Sparling, directed by Rodrigo Cortes, and starring - weee! - Ryan Reynolds.)

This is my first trip to Europe.  In preparation, I have paid the $200 for a rushed passport (stupid name change that I forgot to do on my old passport), had my script for flight-necessary xanax refilled, and I'm working my way through the pile of laundry left over from July's travel binge.  I have scheduled for someone to watch our house, our cats, and our mailbox. 

I've started to compile my diabetes supplies for the trip, including my old Minimed 512 as a back-up pump, two back-up meters in addition to my regular one, glucagon kits, and enough pump supplies, test strips, lancets, and glucose tabs for a month's worth of travel.  (Even though we're only going for a week.)  That's in addition to the bevy of snacks, that bottle of long-acting insulin, the bag of syringes, and ketone strips.  Not to mention my Nikon equipment.  And plenty of underpants. 

I also have dinner scheduled on Friday night with the production team, which includes the aforementioned Reynolds and Cortes, which may require a new pair of shoes.  (See the aforementioned:  weeeee!)  

It's a lot to pack, and my suitcase is already straining at the seams.  How on earth am I going to smuggle back Inigo Montoya? ;)

Getting ready for Spain!!!

I can barely figure out where I'm supposed to be next, but I do need to figure one last thing out for certain:  How am I supposed to manage the time change and my blood sugars while in Spain?

Barcelona is six hours ahead of my current timezone, and at the moment I'm working very diligently (and oddly consistently) to keep my blood sugars harnessed.  The last thing I want to do at this stage in the pre-pregnancy game is let things fall further off track.  So while I want to sample the best of the Barcelona tapas and see the sights (oh, and visit the set of the movie, which will be surreal), I want to keep the lows and the highs to a bare minimum.  I've been tracking my numbers on the "Kevin" spreadsheet, which is working out well.  I've got it saved to a flash drive and I've been bringing it back and forth to work and home with me, and it's also coming to Spain.  So I'm trying!

But I do need some travel advice.  If you have any experience with the following, I'd love to hear about it:

  1. When do I change the time on my pump and meter?  On the plane before I take off?  Once I land?  As we travel?
  2. Do I want to change my basal for that first day of travel?
  3. What can I expect after moving forward six hours?
  4. I'm bringing Levemir as my "in case the pumps break" back-up, so does anyone have any experience with going from pumping to Levemir? 
  5. Also, where should we go in Barcelona?  Any favorite places?
Thanks for any advice you can offer!  As always, you guys are life-savers.

Comments

When I traveled to Japan for a month, I was lucky because of the 12 hour time difference which made the transition easier. It was still tough since air travel alone makes my bs crazy. I would just recommend an insane amount of testing the day of travel and next. Also, half my suitcase was full of "American" snacks, so that helped take the guesswork out of some of the calculating. Just be sure to leave room for the underpants.

Whoa. Wow. Awesome.

Sorry, that's all I got. I have not traveled into a different time zone in years, let alone 'cross the pond.

So exciting tho! It shall be, well, Awesome!! Cannot wait to hear all about it when you return. Travel safe, have fun!

When I went to Alaska (4 hours behind us), I changed the time on my pump when I landed in Canada, then again the next morning when we actually got into Alaska. Then just tested like crazy that 1st and 2nd day. Didn't help that we were on a cruise ship with all that food, but by the 3rd day everything had fallen back into place.

No experience on Levemir or where to go in Barcelona, but OMG meeting Ryan Reynolds!!!

Yes I would reccomend as stated by previous poster an insane amount of testing the day of travel and the day after . I wish you luck because last time I travel across the seas I got sick . also be sure they know you wear a pump at the airport because my friend has had so much trouble with this .Alot of times she has been asked to remove it . Good luck and tell us all about your trip when you get back . travel safe and take care of yourself .

I traveled to Europe when I was younger with my pump so I can't remember all the details but I think it all depended on when I got there. I landed in the the morning (their time) so I just changed my pump to their time and watched my sugars in case they dropped too low. I didn't really have any problems with it. On a lighter note - Barcelona is magical. You will love it...if you can take your eyes off of Ryan Reynolds ;)

You guys are seriously awesome. THANK YOU for the feedback - I'm taking copious notes.

And Ryan is cute, but I remain a bigger fan of that other guy ... what's his name? Oh yes, Chris Sparling. :)

I travel back and forth from louisiana to scotland and it is a 6 hour time difference. I usually change the time on my pump when I land. Having said that, when I fly my sugars tend to elevate so I put my basals up. I put it down to lack of sleeping, inactivity, and high carb plane meals. The first couple of days just keep an eye on your sugars when you are awake at times you would normally be asleep and vice versa. I notice my body wants to keep the old pattern but gradually adjusts to the time zone.

Ditto on changing the time when you land. I didn't notice that too much adjustment was required as far as my basal rates but the hypervigilant testing was definitely necessary on the travel days. Also - if you DO have any issues the Pharmacias are very helpful. On a pre-pump trip to Milan my only pen fell out of my handbag leaving me with NO short acting insulin. After a quick discussion with the pharmacist I was on my way with a new novolog pen - even though I had no prescription - just my meter and syringes as proof of my diabetes. Have a great trip!!!

My husband and I went to Barcelona last year and I LOVED it!

We went to a place in Barri Gotic called PLA and had the best meal ever.

Hit the Sagrada Familia if you can -- it's insane!

I forgot to mention I had absolutely no trouble with time changes -- just changed the pump time mid-flight.

And a lot of the tapas are meat- and cheese-based, which makes carb counting easier!

I travel (and change time zones) a lot. For me, it depends on how long I'm staying in the different time zone. For a week, I'd probably only change to a 4 or 5 hours ahead (instead of the full six). That makes the transition back to east coast time easier for me. I usually move the pump time 2 hours per day until I reach desired time in new time zone. I find a huge shift (like all at once when I land) sends me low and high at odd hours - despite the fact that I'm awake at odd hours, my body's still on the same old schedule.

I have a large dawn phenomen (sp?), so the first night I sleep in a new time zone, I do try to wake up and test at least once, so I don't wake up with a big high and ruin the first full day of sightseeing.

Have a FANTASTIC time! Take LOTS and LOTS of pictures with Ryan!!

Hey Kerri - wish you could fit me in your luggage - next life I come back as a contortionist!!
When I've travelled abroad - I change my pump time to my destinations time as the plane takes off from this side of the pond.
I test abit more frequently over next few days - so I know if I have to tweak my basal settings abit.
I love to visit castles - http://www.weblandia.com/castillos/ - and there are lots to see (I even stayed in one when I lived there - felt like a Princess - cough, cough).
Also, anything along the Med - little quaint villages near to Barcelona - if you get a chance - check them out. If you don't see everything this visit - go back for "Chris and Kerri" adventure.
Ole!!!

The thing with time travel, is that your body never realises it's done it! If your body needs different amounts of insulin at different times of day, it won't realise right away that it isn't the time of day it thinks. This is just the same as your body not realising when it should be awake or asleep. It thinks nothing's changed!

I tend to change the time on my pump clock slowly, by a couple of hours a day. Through trial and error I've developed a specific pattern that works for me, based on how quickly I get over jet lag.

On the first day I try to move my pump at a time that will bring me to a lower basal than would be normal at that time, as I prefer to avoid lows if possible!

The downside: you can't use your pump as a watch anymore! You need to convince your mind that it is totally at the time of your destination from the moment you step on the plane if you want to get over the jet lag quickly. Set your watch, and your meter, to new time as soon as you board and then start thinking and acting at that time. If you keep checking your pump clock, you'll get confused!

Most of all though, HAVE FUN! And next time you come to Europe, come to London!

wow, i'm excited for you guys! i haven't traveled to a different country with my pump (yet), but i have switched time zones while going from philly to ca. i changed my pump time when i landed and tested throughout the flight. i think having your cgm on will help with things too.

when i went to italy a few years ago (still on mdi), i went low in the middle of the night the first few nights. coming from ca, my schedule was out of wack, so even with my bg ok before going to bed, it would crash a few hours later. it adjusted after a few days though.

have fun! can't wait to see your pictures! :D

Ditto changing it when you land. The weird meal times and plane inactivity will make your blood sugars nutty anyways.

In case you need it, insulin pump in Spanish is "La bomba de insulina".

Too bad pump sounds like bomb ;)

Kerri

I travel to Ireland about every 18 months and I believe it's the same time zone as Spain. It's always an evening trip, which helps a lot.

When I arrive at the airport I reset the time on my watch/pump/Dexcom. Then I start behaving as if I'm already at that time. Which means a light meal, if any, and lots of water. Once I get on the plane I try to sleep most of the flight (eye shades are a big help).

Arriving in Ireland in the early AM I act as if it's a normal day for me. By 4 PM I'm really dragging but I try to stay awake until 8 PM. Then I have no problem falling asleep and usually I'm fine for the rest of the trip.

Have a blast, send postcards. :-)

Sorry Kerri, I can't help with the questions as I'm non-insulin T2.
But seriously Kerri, I clicked on the Buried link and saw the oh-so-cute Ryan Reynolds and read the blurb about the movie. So you sleep with this guy who imagines and writes about waking up in a coffin!!?? What an amazing and crazy pair you must be.
Have a wonderful time in Spain and keep in touch if you can. I follow you on twitter as well as in my Google Reader.

I am a newly diagnosed (since 5/2009) Type 1 and very anal retentive. So of course after the earth stopped spinning since my diagnosis I was determined to track my BG but did not want to carry around anything to cumbersome. I have found that the Glucose Buddy (www.glucosebuddy.com) app for an iPhone or iTouch is GREAT. It allows me to enter BG, carbs, exercise, and insulin on my iTouch so I can keep a record of it, see a graph, and it gives me my averages. You can also download it to your computer and see additional graphs that help you analyze trends. I went out a bought an iTouch just for the app. I highly recommend it. They are also coming out with an A1C calculator.

We made our first out-of-time-zone trip just 6 weeks after my son went on a pump. Our pump trainer told us to use one of two alternatives to set the pump to the new time zone. 1. Set the pump forward (or backward, whichever) 1 to 1 1/2 hours per day until you are at correct local time. 2. If you are moving to a time zone two hours ahead or behind your starting time zone, wait two days, and then reset the pump to local time, three hours, wait three days, and so on. We chose the first option for a trip with a 3 hour time difference and two trips with a six hour time difference. This may seem confusing (especially since we always set the meter to local time when we land) but if you have radically different carb ratios or basals at different times of day (as my son does) this works well.

I can't help you with pump information, but I will say, if you haven't heard, that dinner in Barcelona is late--most people don't eat until 9 or 10 at night, so be prepared for that possibility. Also, don't forget to drink from Font de les Canaletes, the fountain on Las Ramblas. It doesn't look like much, but legend has it that whomever drinks from it will return again and again to Barcelona. One of my very favorite cities in Europe.

My husband and I recently took our first big trip with my insulin pump. We live in WA state, and flew to Maine with a 3 hour stop in Philly. I changed my pump and meter time at both time changes and had zero blood sugar problems! I was concerned about my basal rates because I have a pretty significant dawn phenomenon that I compensate for. I kept checking my BG about every hour, and just shifted my meal schedule to sync up with the local time zone, even if it meant eating an early (but smaller) lunch.

my daughter sees the team at CHLA, particularly Dr Kaufman. She has told us not to change with travel, just change time on pump when you get on plane. she travels the world with kids with diabetes, so i trust her judgement!

we have done levemir as well, but 2x a day (every 12 hours worked great for us!)

Kathryn and Emmy

Hi Kerri, I have been reading you for a few months (type II) and I live in Seville. Change during your flight (about 4hrs. into), and if you really want to eat good food (veggies too) try Pa'torat. Ask at your hotel, they'll know where it is. EVERYONE in Barcelona eats there...it's amazing!
Good luck, and I will be reading your posts. My cell phone in Spain is 685.95.3787. Call if you need anything. Ps. my mother is insulin dependent, so I understand your concerns.

Can't help you on the Diabetes front, but I can give you a few suggestions for sight-seeing in Barcelona.

Definitely visit La Sagrada Familia. Very cool. Definitely worth it.

Park Guell is another must. (Designed by Gaudi)

Casa Mila(also known as La Padrera) is also worth a tour. Yet another Gaudi-designed building. Can you spot a theme here? LOL

Take plenty of photos, and have a good time.

-Ryan

Hi Kerri, I cannot help you with but information because I still do shots. I often travel to Europe and to help with jet lag and diabetes stuff I try to adjust my internal clock before departure, like waking up, eating and going to bed earlier. It really helps!
Have a great trip!

I travel internationally on an almost monthly basis with my pump and dexcom.

I always switch the time on everything before I go to sleep on the flight. I also keep my Dex clipped to the seatback pocket and watch it like a hawk. Tends to work out just fine.

Security screeners in Europe haven't seen a lot of insulin pumps. To avoid the hassle, I just disconnect mine and put it in my purse before going through security. If you aren't comfortable doing that: "Soy diabética y necessito esta para mi medicina."

Love Barcelona and have a fabulous time!

I haven't traveled enough since I've had the pump but when I do fly my BG seems to be higher while flying and drops when I land...since it is still unpredictable I test a lot while I travel. Sorry i don't have better advice! I was in Barcelona a few years ago and two of my favorites tour attraction spots were Parc Guell, designed by Gaudi (which someone mentioned above) and Salvador Dali's house in Port Port Lligat, Cadaqués..which is about two hours from Barcelona. I also enjoyed being a complete tourist and taking one of the red tour buses around Barcelona! Have fun!!

Hey, Kerri. I read your blog daily and it has been a great help since being diagnosed (T1) last November.

I went on the pump in May and frequently alternate between the pump and Levemir. I usually take my Levemir at night before bed. Be careful if you've exercised a lot during the day. My doctor always recommends a snack before bed (if on Levemir) and told me to have my blood sugars between 100 and 160. I went waaaay low in the middle of one night because of walking before bed. The next night I had 2 glasses of milk (without a bolus) and did fine.

Barcelona is one of my favorite cities in the world and you'll love it. One of my favorite things to do is just stroll down Las Ramblas and walk along the beach. I echo the recommendation for La Sagrada Familia.

This is what I've picked up in traveling over the years (lived in the UK for a year, lived in the US with extensive travel for the other 29 years -- been diabetic for 27 of those years):

1) On pumping, I change my basal profile halfway through the flight to the new time zone. For me, if I don't do that, I'm spiking when I get there because I've missed the basal to cover my dawn spikes.

2) I set a temp basal at 30 percent increase while traveling. I've found that sitting around a plane and an airport = higher numbers. Since people look at you funny if you start doing wind sprints in the airport, a basal increase is just easier.

3) If you don't speak Spanish, see if Medtronic has a travel card that you can take with you that explains what the pump is, and why it can't be removed. Animas sent me one to keep when I got a loaner pump from them in November, and it was invaluable when I was in France in December. I don't know how to say "It's an insulin pump. I need it. Don't x-ray the loaner," in French, so I handed the security officer the guard, who found his supervisor to explain it to him.

I cannot help with insulin information, but I can tell that when we were there we enjoyed Sagrada familia and casa Batllo.

Food is very simple in ingredients & preparation, so will be easy to count the carbs.

They tend to eat a lot of bread, but you can skip it.

Meals are late as other person commented, so have always your snacks handy.

Hopefully you will walking a lot (that can help too with the sugar levels).

Have fun & congratulations on your husband's movie to-be.

I went to Hawaii back in March and they were 5 hours behind my time zone, central, and I changed the time on my pump when we landed in LA to Hawaii time and tested like crazy the first 3 days but wasn't much help. I still had horrible highs and lows for the first 2 days and then they started to settle down. Flying always messes my bs up. I had more problems with lows than I did with highs. Day 2 I actually suspended my pump and took it off for about 12 hours and when I "hooked" back up I was normal, well I wouldn't say normal but I was within a reasonable range. Coming home I had the same problem. But I landed on Monday morning and was at school by noon that same day and I should have probably stayed home and adjusted back to our time zone.
I have no good ideas for Spain, I have never been.

i specifically started pumping before my trip to bulgaria, the netherlands, germany, and belgium last summer. the paris airport security guys had a great time trying to figure out my big ass container of omnipods....
so:
check your blood sugars like ker-azy, change the time on your pump when you land, and have a great time. by the way, it will be much easier for your body (and, therefore your blood sugars) to adjust to the time change if you hit the ground running and just begin living in the time zone where you are. take NO MORE than a 20 minute nap.

Pump settings? Who cares! You might need a whole roll of glucose tabs to help you come to when you meet Ryan. (Gorgeous)
Have fun!

One amazing place that I've read about and have seen photos of is La Sagrada Familia - it's an unfinished cathedral that is absolutely strange in design. Think you'd love it, but hoping if you visit it that you take a gazillion pics of it. Have never been, but all I've read of it is fascinating.
Hope you have a fantastic time!!!!

my only advice - non practical - ENJOY ENJOY ENJOY ENJOY. This is going to be one of those times that you're still talking about when you're both old and sitting in your rockers, telling your grandkids "one time, your grandpa and I went to Spain...."

Wow! Reading your travel prep makes me realize how unprepared I usual travel :p I've lived in Europe three times and never taken a back-up pump (my first two trips abroad I was still doing injections). That said, I've never had a major problem with my pump. Guess I've just been lucky and should be a little more responsible moving forward.

Anyway, it seems like you're covered with pump related travel advice, so I just have to second the recommendations to visit La Sagrada Familia and Park Guell - my two favorite spots in Barcelona! Also, be sure to enjoy some paella, believe me, it's worth the carbs.

Have a great time and tell Ryan hi for me :)

Hi Kerri,

I've never posted on your blog before, just a lurker. I have a bit of travel advice for you, as I have traveled to Europe a few times since I've had Type 1. This spring, I traveled to Europe the first time with my pump. We went to Denmark and Italy. While in Copenhagen, the gate agents at our airline told me that security there may make a fuss about all the pump/diabetic supplies I was taking in my carry-on. The problem was with the sharps. They said security may only allow me to take enough sharps in my carry-on for the duration of the flight. So what I did was take about three infusion sets and I put the rest in my bag. Security didn't complain, but I didn't want to take the risk of having them take all my sets out of my bag, and packing them in some random box and them ending up in who-knows-where.

I haven't encountered this rule anywhere else in Europe, and I haven't been to Spain yet, so just a heads up in case you encounter this strange rule! Have a fun trip!

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