Category Archives: Peter Jr

The challenges of traveling with Type 1

For the first fourteen years of my life, I didn’t have a worry in the world. I would pack my bags and leave with my family to a conference or go on a long hiking trip and only have to worry about having enough clothes along and maybe a book to read. If I didn’t pack enough undies or socks it would maybe make me a bit uncomfortable but certainly
would not be life-threatening!

canstockphoto71865801Since my diagnosis last April those days are no more. Now my very life depends on having a proper supply of insulin and other supplies at all times. You would think something this important would be easy to manage right?

Perhaps if I was living a more conventional life, spending most of my time in one house with my medicine in one fridge it would be a bit easier. We on the other hand are full time travelers and move from country to country and hotel to hotel. Sometimes we get up early and catch a shuttle to the airport at 5 AM for an early flight making it even more difficult to manage.

If you have type one diabetes and are struggling to adjust to the new lifestyle, and occasionally forget your medicine, don’t worry you are not alone. I guarantee you will feel better about yourself after reading my story.

I have had several “insulin management” challenges all over the world.

The first time was about 6 weeks after I was diagnosed. We were in Oregon and I left all of my supplies at a restaurant. I didn’t think about it until we got back to our camp almost an hour away.

We were able to retrieve it after a few phone calls and a few hours of driving.

We were visiting my Grandmother in Salem Oregon and as usual we put my insulin supply in the fridge. Insulin needs to be kept cold or it can spoil. After a nice visit we headed out to Bend Oregon about 2.5 hours drive away. When we arrived I realized I had left my supplies behind. My Aunt Arwen was kind enough to drive them all the way out to us! Thanks Aunty!

I left it again a few months later in a restaurant in Texas this time we got it back more quickly but the problem had yet to be solved. My Dad is a systems guy and he said to me “we need to develop a system to help us manage this better”. I agreed.

My next big “Insulin management” challenge came when we went from New Zealand to Australia. We decided to leave our main supply of insulin at our friend’s place in New Zealand.

We packed enough for the 25 days we were planning to be there and carefully placed the package in the fridge at our hotel room – ready to go for our 5 am shuttle ride to the airport. When we arrived at the airport and began checking in for our flight we suddenly realized that we had left the package in the fridge at the hotel. My dad quickly called the hotel. They ran up to our room, found the package in the fridge, gave it to the shuttle driver and instructed him to deliver it to us in departures. He made it on time and we still had time to get through security and make our flight to Australia.

We had a lovely “incident free” time in Australia. We visited some lovely places and met wonderful people.

A month later, just as we were about to fly back to NZ, we received news that our Jeep wasn’t going to arrive in Auckland for another 24 days as the ship was delayed due to a large Hurricane.

We made a quick last minute decision to stay in Australia for another 24 days. This of course left us short on insulin. I was able to visit a doctor’s clinic, get a prescription or “script” as they call it and then buy a backup supply of for Lantis, Humalog, test strips, needles and lancets. One nice thing is that in Australia they actually sell the AVIVA brand of tester supplies like I was used to from Canada. Some countries like New Zealand will carry different blood glucose testers which makes it a bit difficult to manage your BGL because you get used to your system and it’s hard to change. We bought enough to last 3 months just to be sure of no further issues.

Because of the length of the delay of our jeep we decided to visit Bali now rather than after our trip to NZ as originally planned. A few days later we packed our bags and headed to the airport.

An hour into our flight from Adelaide to Denpasar, Indonesia, my Mom jumped up and yelled “KEVIN!!” actually she said “oh no! we left your insulin supply in the fridge! Not much we could do, there was no turning around now.

I did a quick calculation and figured I would be ok with the partial insulin pen I had in my backpack. Our visit to Bali was for about two and a half weeks and I had enough to last if I were to eat a very carbohydrate conscious diet.

A week into our trip and I realized that the Balinese diet was anything but low carb and soon I began to get low on both Lantis and Humalog insulin. My Dad began calling and dropping in at local pharmacies to see if he could buy some more. Finally after much searching we were able to visit a remote hospital where the very helpful doctor sold us some of their supplies. The applicator pens were different than the ones I am used to, but after reading the labels and documentation it appeared that the product was the same. We had enough supplies to make it back to Australia safe and sound.

Now what have we learned from all of this?

Here are the main challenges:

One. Leaving my daily insulin bag under tables at restaurants.

Two. Leaving my main insulin supplies in friends’ and hotel fridges.

Solution 1:

The first thing we thought of was to buy a bigger better
bag to carry my daily insulin and supplies. The one I was leaving behind was a very small fanny pack style bag. Initially we thought the smaller-the-better, but all that did was make it easy to leave behind.

To solve the problem, we chose a “Patagonia Atom Sling”. Any brand will do but this bag is made tough, has lots of room and is comfortable to wear.

 

I have been happy with this solution. The larger bag easily carries my gear, is comfortable to wear even on long hikes and doesn’t make me feel like a tourist carrying a fanny pack.

 

Solution 2:

The next thing we thought of was to pack all of my insulin the
night before we leave removing it from the fridge and placing it in my luggage with an ice pack. This prevents us from accidentally leaving it in the fridge of the hotel before an early flight.

Solution 3:

The third system we implemented was to use the alarm system on my iPhone. We normally set an alarm to alert us of an early flight or departure. Now we name the alarm “REMEMBER TO CHECK INSULIN SUPPLIES”. Before turning off the alarm we are reminded to check our supplies.

All three of these systems have really helped me manage my insulin supply better and have made traveling with T1D a much better experience even though I still forget from time to time.

A few weeks ago I forgot my bag in a restaurant in the town Te Anau and didn’t notice until we were 3 hours south in Bluff NZ. We called the restaurateur and he went looking for it and found it. He said hang on there for a minute and left the phone.. a few minutes later he came back and said “you’re in luck. I caught the last truck out. The driver is a friend of mine and lives near where you are staying. He is going to deliver it to you”. What a relief, I was so thankful! Along the way we’ve met some very kind and caring people.

Let me know if you have found this post helpful and please share any tips or tricks that have worked for you in the comment section below.

Peter Jr van Stralen @petervanstralenjr

My First two days in Bali.

By Peter Jr – 14 yrs

On January 7th we said goodbye to our friends and family in Australia and boarded a plane to Bali. When we landed, we picked up our backpacks and were greeted by our driver holding a sign with our name on it. After a hectic drive from the airport to the central village of Ubud, dodging oncoming traffic and more motorbikes than we could count, we arrived at the Tjampuhan Hotel. As soon as we walked through the reception area we were greeted by the friendly staff, and a peaceful jungle view, overlooking a steep river valley. 
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After a good night sleep, we woke up early and went out to a remote village to see how the rural Balinese people live and work everyday. That was one of my favorite things to do. Working in the rice fields with the mud and the cattle really showed me how much work goes into something that I used to take for granted. I had the unique opportunity to drive the cattle drawn plow through the rice fields to level it of in preparation for planting.

We then were given bundles of rice shoots to plant deep in the mud.IMG_5669.jpg We were instructed to plant 2 – 3 three rice shoots in each area. At first I was very slow at it. The mud was deep and sticky and it held my bare feet in place like a suction-cup. I was thinking it would take a month to plant the field at this rate. Over time however I was able to move along fairly quickly.  Watching the locals I was amazed at their speed and accuracy, planting row after row in beautiful straight lines. The rice is planted in a flooded field and remains underwater until the grains begin to grow on the stems. As the rice ripens the fields dry up and become ready for harvest.

The next day we woke up early again to visit some very culturally img_7171significant sites. The first visit on our list was Pura Besakih also known as The Mother Temple. This is the largest and holiest temple in the Hindu religion in Bali. It sits about 1000 meters up the side of Mount Agung in the North eastern part of the Island. When we arrived, our guide explained to us that the Mother Temple was actually 23 separate temples in one. Out of respect for the people, we wore the traditional clothing which included a sarong (robe), a sash and an udeng (hat). Here is a photo of us all dressed up for the occasion, although I stuck to my traditional baseball cap because wearing a skirt was already as far out of my comfort zone as I wanted to go.

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Next on our tour was a visit to see Kerta Gosa, the ancient court of justice located in the center of Bali. This is where the supreme King used to judge and pass sentence on those who have committed a crime. 

courtroof

It was quite surreal. The original building was built in the 1600s which makes it definitely one of the oldest buildings I’ve ever seen. On the ceiling were hundreds of paintings depicting the crimes and punishments according to the law of the day. Rather than volumes of law books and case studies like today, this was their legal system. Not only were you punished for your crime, Karma also took care of you. Double the reason to be good.

Stay tuned for more stories from my adventures in Bali, Indonesia.

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My Type 1 Adventure


The first time I felt something wrong was in Canyon lands National Park Utah. We were on a hike circling a huge crater, it was called the sync-line trail it was listed as only 8 miles round trip so we didn’t think to much of it.

canyonlands2
Overlooking the Canyon Trail ahead

As the hours passed and the trail showed no signs of ending we started to get a little worried, we were a long ways out in the wilderness, the trail was hard to find and the sun was starting to set. We just went deeper and deeper into the canyon and we all started to wear out a little. Eventually we came to the part of the trail that started upwards, a trail sign said 4 km to the trail head. We thought we would be back in an hour or so until we realized that the trail was 4km straight up the canyon wall.

canyonlands3
I was full of energy on the way in to the Canyon
canyonlands
We still had to go all the way down to the riverbed and than up the other side.

That’s when I felt something wrong, I just started to lose all of my energy rapidly and cramped up to the point that I just stopped. My Mom stayed back to encourage me and she gave me some energy gel. That got me going again. My dad went on ahead to see if he could mark the trail before it got dark. When he saw my predicament he climbed back down to where we were and carried my backpack on top of his own. Eventually we all made it back to the end of the trail.

Watch the YouTube video of our epic hike here: https://youtu.be/lE9HrbHNC2E

I had never felt that way before and I was embarrassed about it so I said nothing. I would have good days and bad days, one day I would be surfing all day without any problem and the next day I would sleep in and stay in our RV. They say once you finally figure out whats going on it all makes sense, but at the time we just chalked it up as the signs of a rapidly growing teenager.

birthday
Sitting (Daniel and Royce) on Hammock (Aliza, Beatrice,and Braydon) Standing left to right (Remington, Caroline, Izzy, Kate, Sylvia, Sam, Emma holding Luna, Me, Harrison)

My birthday party was at my cousin’s house in Salem, Oregon. Most of our West Coast family was there. I looked fine on the outside, but I noticed that I was drinking water obsessively and going to the bathroom a lot. One time when I went to the bathroom I looked in the mirror and opened my mouth because my tongue was hurting, and it had a white film on it. I didn’t know why and didn’t think much of it, so again I didn’t say anything.

I woke up the next morning , looked outside and noticed that I couldn’t see more than 5 or so feet in front of me. These symptoms had slowly worsened but I felt so tired all the time I didn’t really notice till then. I thought it was from over sleeping and not being really active, because every time I would start to do something I would cramp and get even more tired.

I discussed my vision issues with my parents and we agreed that maybe I should wake up earlier and go with them on their morning bike rides. At this point I had been feeling every symptom of type one but had no idea that I had it. 

We headed down to Yosemite in California and set up camp in the National Park. The next day, everyone was excited to hike the amazing Yosemite falls trail except me. This trail is a strenuous 6-8 hours round trip, 7.2 miles (11.6 km) , 700 ft (823 m) elevation gain. Normally I would be at the front leading the way but this time I could barely muster up the energy to go. That’s when we all agreed that we better pack up and head out to get a Doctor’s opinion on whats going on.

We were 5000 kms away from our family doctor, so we probably delayed the visit to the doctor longer than we would have done if we were at home. We found a clinic in the tiny town of Oakhurst CA and waited 4 agonizing hours until a nurse finally saw us. She listened to my description of symptoms and suggested that I go to the Valley Children’s Hospital near Fresno to be tested for diabetes. Amazingly this hospital specializes in

hospital-card

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Giving Thanks – Today we were released from the hospital.

Pediatric Endocrinology and was only an hour way. Once we checked into the hospital I was immediately put on an IV drip to help re-hydrate my body. I was also given blood glucose test which showed my blood sugar was very high. The doctor confirmed that I indeed had new onset Type 1 Diabetes.

We were in shock.

(Watch youtube video blog of that moment here: https://youtu.be/YC0nk-AHnLs)

He assured us that there was nothing I did to cause it and nothing I could have done to prevent it. It is an auto-immune disease where my immune system accidentally attacked the beta cells in my pancreas stopping them from producing insulin.

Thankfully I recovered quickly and my family and I have since been learning to manage my blood sugar levels through, diet exercise and by administering my own insulin injections. It is not easy though and takes a lot of self-discipline. Thankfully my family is very supportive and together we have all adapted to a diabetes friendly low-carb diet.

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Sitting on top of the world

Two months later I was feeling well enough to join my family on a climb of Oregon’s third highest peak. It is 10500 ft to the summit.  Every time we stopped for a break I would test my BGL levels and eat something to bring up my level to where it should be. At 9300 ft. (Pictured here) I was feeling a bit off so I made the decision to stop and rest rather than carry on to the summit. You have to listen to your body and not be afraid to make the right decision. My Mom and Brother stayed with me as Caroline and Dad summitted and then rejoined us for the long descent.

 See our YouTube video of the climb here. https://youtu.be/aIOZwI-3PMM

In the past 7 months since my diagnosis I have climbed several mountains, hiked, mountain biked, rock climbed, traveled the ultimate road trip to Alaska and flown across the globe to New Zealand and Australia.

My goal is to encourage other young people with Type 1 to carry on and be strong. You may have diabetes, but it doesn’t have you! I wish you all the best on your adventure. – Peter Jr van Stralen