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From Abby: Vacation on Virginia Beach!

Abby was on vacation last week (and was missed - sorry for throttling your inbox!), and while she was on 'real vacation," she also took a pump vacation.  But diabetes wasn't playing according to plan, and she tells the story of how vacation wasn't all rainbows and ... you-know-whats.

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So I graduated from nursing school, signed a lease on an apartment for the fall, and helped my mom pack up and move the house I grew up in … all in one week. I needed a vacation.  A good friend from College Round 1 and I had planned a trip to Virginia Beach about a month prior, and it came at the perfect time.  I just really wish I could have left diabetes in New York ...  I wouldn’t say that it ruined our vacation, or even really negatively impacted it, but diabetes made its presence known plenty of times.

I decided to go on Lantus and Humalog again, because I hate pump tan lines, I get eeked out that my insulin will go bad sitting on a hot beach in my pump all day, I’ve gotten some nasty pump site infections after being on a beach, and I didn’t want to have to disconnect and leave my pump under my towel when we decided to go in the water. I’ve done this plenty of times.  Lantus and I have gotten along really well in the past, but I guess we are no longer friends.  I have to say, I should’ve seen this coming. My basal rates vary from 0.60u per hour to 1.1u per hour, so that steady flow of Lantus just doesn’t work for me right now.  (Live and learn, I guess?)

The really cute middle of the night lows I had were fun. The first night at 3 am I was 36 mg/dL, and the next night around 2am I was 44mg/dL. That was cool. (Probably why I have a 0.6u basal rate from 12 am - 4 am … duh.)

We found this wicked cute restaurant across the street from our hotel that made these DELICIOUS drinks called “Orange Crush."  We went out one night after dinner and discovered these most wonderful concoctions, and that they were half off at happy hour – which meant we had to revisit.  That first night didn’t do much damage to the blood sugars (upper 200s with a 56mg/dL at 6 am).  It was the happy hour drinks that killed me. We also got some crab dip to go with our super sweet drinks, and I left my Humalog in the room (again, insulin on the beach seems bad to me) so by the time I got home I was 479mg/dL. This resulted in dinner at 9 pm when I was finally back in the low 200s and starving. I realize this was totally my fault, and that there were much smarter ways of having fun, but gosh darnit it’s frustrating to not be able to go to happy hour on vacation without a stupid blood sugar after.

And don’t forget about the pre-creamed and pre-sugared iced coffee that they conveniently have at 711 (which is on every single corner in Virginia Beach, yet not a Dunkin Donuts in sight).  Took one sip of that delicious liquid candy and had to pass it on to my friend while we set out on a hunt for some place that would hold the sugar for my pancreatic problems (McDonald’s to the rescue!).

Diabetes didn’t totally get in the way though.  We ate really sensibly (minus the one lunch out with a giant BBQ burger, and those two days of drinks) which helped things, and my sugars ran a bit high but I was okay with that.  (There’s nothing worse than a low on vacation on the beach while your hands are all sunscreeny and sandy.) I also made it out pump site tan-line free, and with only a few spotty sunburns. 

Lesson Learned: Practice with Lantus and Humalog for a few days next time, or bring pump for backup, or figure out a way to turn pancreas back on for a week.

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Welcome back, Abby, and thanks for posting.  Also, HAPPY GRADUATION!!!!  We're very proud to have you as "one of the good ones" out there in the medical community. 

Comments

Yes! Congrats Abby! Great job!

My friend and I 'invented' a fabulous drink a couple weeks ago and appropriately named it a "Blood Sugar" because I was so amazed at my near perfect, no hitter, 12 hour view on my Dexcom the next morning. Crystal light and vodka (we also cut up some strawberries to put in it!). No sugar, no carbs, no cals, AND freaking delicious. I know you can't order them at happy hour, but it is a good girls night drink instead of a 400mg/dl+ BG that is sure to come from margaritas.

Great job on finishing nursing school, Abby! I've got another seven years until I can even think about graduating med school, so uch, but you're finished! Yay!

Also, I don't know if this will work for a pump, and I know you have other problems with bringing your pump to the beach, but I went to Six Flags a couple of days ago and it was abour 100 degrees in the park. I was scared for my meter, my EpiPens, and my inhalers, which all have to be kept at under 85 degrees or they'll die (in my mind, give or take a few). So I stuck a little ice pack in the bottom of my bag, put food on top of that, and then on top of that, my meters and everything else. That way, they were kept reasonably cool without going under the degree limit. It was a nice trick, if I do say so myself, and it worked beautifully. Just in case you ever decided to ignore all the other problems you have with bringing your pump to the beach...

Abby, thank you SO much for posting about this! I have been considering taking a pump vaca. (been on one for 15 years straight now; it's time dontcha think?) My concern was my basal rates at night that are HALF what my daily rates are (.575 vs 1.125) and how that might work with Lantus. Thanks for your input. Maybe a pump vaca isn't so interesting to me after all!

Congrats on completing nursing school!! :)

I had a night away with my sister recently, and while I was sipping my margarita and eating Mexican food all I could think about was the impact this would be having if I had D. How would I bolus for this? Especially since I was planning to drink more... and how would I decide what to drink... and how often would I need to test, and where would I keep my supplies in my little clutch that could barely hold my phone... and would I even want to have my pump on? Could I actually inject at a club without having the cops called? lol Would I be safe?

OMG, ladies (and gentlemen)! I admire you and what you deal with every day. I am obviously surrounded by diabetes, (and possibly a little obsessed, lol) but I can get away from it now and then. I would give you a night off, or a vacation if I could.

I'm glad your get away wasn't a complete blood sugar nightmare. Hopefully next time will be better. :)

Abby,

Congrats on graduation! And so sorry to hear of the nasty blood sugars... we've all been there for sure! I know this probably isn't what we are told to do, but I haven worn my insulin pump on the beach numerous times and never had any decomposition problems with my insulin. You could maybe even bring a back-up vial just in case you notice your insulin going bad? BUT, this doesn't take care of your site tan line problem :( I say we all go for your last suggestion and just get our pancreases working!!

Tammy,
If I were to try this again I'd make sure that I ate a high protein snack before I went to bed. Once I started eating a snack before bed (and fully bolusing) I was waking up around 8am with BGs in the low 80s, high 70s. I just had to figure that out. Talk to your endo maybe there's an easy solution to this problem!

I am glad I'm not the only one that does that kind of thing. Sometimes I feel like a bad CDE for allowing myself the vacays but sometimes they are just freaking necessary! Thanks for the post! You'll be a great RN!

I always skim something before I actually read it...and I saw the 711 as a blood sugar!

Happy Graduation Abby! Congrats!!! And, bummer on the Lantus/log MDI gig. However, I do appreciate the lessons learned. Also, this is so interesting to me, b/c I haven't considered taking Joe off the pump for anything....but it actually made sense...with the beach and the whole pump under the towel bit.

Great experience sharing.

I've considered and rejected a complete pump vacation because I hate dealing with shots and my basals vary a lot. My basal goes from 1.5 to .9 to .5 at night/early morning, but is consistently around 1.0 during the day. But.... after some testing I have found that lantus indeed keeps up with its 24 hour promise, making it a dangerous choice for someone like me who needs practically no basal in the wee hours of the morning. Levemir falls short at around 12-14 hours, making it perfect for a disconnected day at the beach, and an easy hook back up later after I'm off the sand and out of the sun. I keep the pump in the cooler or in the hotel for the boluses during the day. There's some lag after dinner when the levemir is finding its way out of my system, but a temp basal or a snack takes care of it.

CONGRATULATIONS ABBYYYYYYYYYYYYYYYYYYYYYY!!!!!!!!!!!

I'm so proud of you! And SO glad you're out there helping change the world.

Sucks that you had to wrestle with diabetes for so much of your vacation. I hate that stuff.

Hi! Thanks for the post on vacas. The pump doesn't work for me (infusion set allergies), so I had to brainstorm an everday solution to prevent hot insulin all summer. I got this bag from cooler couture. It works for every day, but would also make a great beach bag! Best of luck!
http://www.medicool.com/diabetes/diabetes_travel_cooler_couture.php

Abby - congrats on the graduating!! That OJ Crush drink would have made me drool - more - more - more. I did a 6 month pump holiday last year - went well for me (darn Lantus) - until stuck in a couple of bad days of sailing. I REALLY missed my pump those days - but luckily - had brought it with me - and replugged myself in - and then hit the Sackets Harbor Brewing Company for $2 pints over the next few days while we took a break from sailing!

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