Walking Through

Feeling the weight of my satchel, I headed straight for the chairs the minute I walked through the sliding glass doors. I pulled out my giant toiletry bag filled with insulin, skittles, infusion sets, insulin cartridges, a demi pen, Lantus, spare batteries, needles, Lancets, Rockadex patches for my FreeStyle Libre, and my spare meter that would allow me to check for ketones.

I pulled a small key out of the coin pocket in my wallet and unlocked my suitcase, wondering what I didn’t need in my carry on. I began to pull infusion sets and insulin cartridges out of their elastic bands, thinking I would only need 1 or 2 at most for my flight. I threw the bag of Skittles into my suitcase, knowing I already had 50g of carbs – and some Easter eggs – stashed in my meter pocket. I hated how much space the insulin boxes took up in my bag, and how unnecessary they were to carry with me.

After some shuffling around, my subconscious began to doubt my actions and I eventually threw everything back into my toiletry bag to carry onto my flight to Melbourne.

I shuffled through the documents I had in my clear plastic wallet, making sure I had my spare script for insulin, my travel letter, my travel itinerary, and a copy of the plan I had left with my family containing all the details about my diabetes management should something happen. I saw the brochure I had thrown in about insulin pumping during a flight, and began to realise I hadn’t even given this enough thought.

I locked up my suitcase once again, and began to walk into the direction of Terminal 3 to check in. My subconscious kicked in once again, and I quickly doubled back towards the seats I had stopped at, to make sure I hadn’t left anything behind.

Are you carrying any sharp objects in your luggage? I was asked at the check in counter.

I have type 1 diabetes, so I’ll be carrying needles and other diabetes supplies on the plane.

That’s fine. I was given my boarding pass.

I stuck my head into the Dome, thinking about stopping for a coffee and some breakfast. I glanced at my watch, knowing I had enough time. My subconscious bugged me again, reminding me of possible crowds and that I would be walking through with an insulin pump for the first time.

Frank’s subsconscious won again, as I made my way to the walk through. I began placing my bag, watch, phone, wallet and belt onto the trays.

I’m wearing an insulin pump, I said to the security lady, pulling it out of my pocket and gesturing wildly.

I have DIABETES. Walk through and wand is fine, but I can’t have any X-Rays.

I felt like I was trapped inside a bubble, trying to speak as loudly and slowly and clearly as I possibly could.

Take off your shoes, she said, offering up a tray for me to put them on.

I walked through, waiting anxiously for a beep that didn’t come.

As I began to put my shoes back on, loop my belt back around my jeans, and place all the other loose items back into my pockets, I breathed a massive sigh of relief that it was over.

I don’t fly very often, and this was my first time travelling with a pump, but man diabetes sure does add to the anxiety.

Diabetes Advocates Day

On Saturday, I was invited to be a part of Medtronic’s inaugural Diabetes Advocates Day. The event brought together a small group of advocates from around Australia at Medtronic HQ in Melbourne. Some of the advocates in attendance were familiar faces, while I briefly met others for the first time.

The day began with a coffee stain on my nice shirt and Chinos, as I discovered that my cappuccino had two lids placed on it! 

On the subject of book recommendations, I got to muse at the amount of times I get ridiculed at home for picking up a new book and not finishing it! (Yet I call myself a writer…)

Despite all of the creative minds in the room, the best hashtag we could come up with was #dAdvocatesAU, not to be confused with all the Dadvocates out there!

Going into this event, I was half expecting a big announcement. I knew full well that Medtronic’s hybrid closed loop system – an insulin pump that automatically regulates basal insulin based on CGM readings – is being rolled out in the US later this year. Although there was no announcement of the sort, we did get to hear about research currently underway with these systems from endocrinologist David O’Neal.

One of the most fascinating things to hear was the acknowledgement that overnight insulin needs can vary by as much as 200%. I only recently wrote about my own struggles, and having to tweak my overnight basal rates at least once a month.

We were shown research participant graphs of several nights where different foods were consumed, and how effectively the hybrid system was able to regulate blood sugar levels.

There were a few reactions in the room at one of the graphs, where a patient drank a glass of juice without giving any insulin for it. This triggered a very insightful discussion about placing our trust in the technology. There were advocates in the room who expressed that they felt the most comfortable and in control with multiple daily injections. Many of us couldn’t imagine not treating a hypo, and letting the pump suspend insulin delivery to stop glucose levels from falling below target. As technology advances, those of us using it will ultimately have to move past years of training we have received from diabetes healthcare professionals, as well as our own habits and tricks that work for us.

The most engaging part of the session was hearing from Eduardo Chavez, Medtronic’s Market Development Consultant. He expressed that technology is not able to adjust to real life. Our food, our sleep, and the activities we undertake during the day are often spontaneous and vary each day. That’s where the concept of Sugar IQ comes in. Sugar IQ is a real time, personalised and actionable mobile assistant in development from Medtronic. The underlying idea of this app was to make daily management tasks easier, and with less effort from the user.

Logging data is tiresome. If I’m going to log carbohydrates, insulin doses, and blood sugar readings, there has to be a clear benefit for me. While the app analysed CGM data and highlighted trends or patterns to the user, I felt that it didn’t go as far as giving the user actionable suggestions. I know that there are a lot of regulations around mobile applications giving medical advice, but many of us pointed out that it was unrealistic for the user to be able to get in touch with their healthcare professional every time the app suggested so. I also felt that the app would have been more effective if it were compatible with a wider array of pumps, meters and CGM systems. It will be interesting to see how our discussion influences the development of Sugar IQ going forward.

After breaking up for some brief group activities, the day ended with a GoPro group selfie. It was a jam packed day full of stimulating and insightful discussion. I guess my only disappointment was the lack of time to network with the other advocates in attendance. Big thanks to Medtronic Diabetes for inviting me to be a part of this event, and be sure to check out the hashtag #dAdvocatesAU on Twitter to view the discussion from others in attendance.

Disclosure: Medtronic Diabetes Australia covered my travel expenses to attend Diabetes Advocates Day on Saturday. They also put me up in a hotel on Friday evening and provided morning tea and lunch at the event. I stayed in Melbourne for 3 additional nights at my own expense. There was no expectation that I would blog about the event, and all thoughts and opinions expressed here are my own!

At the End of the Pier.

I stepped off the tram, and out into a blustery, wet Monday morning. I made my way down a deserted street. The left side was filled with tired looking town houses and units, most of which were hidden behind fences and overgrown trees. Behind the fences on the opposite side of the road, I could see stagnant wheels and rollercoaster rides of what would almost certainly be a deserted day at Luna Park.

I reached the end of this tiresome road. Across it I could see palm trees, which were bordering an observation deck that looked out onto a very grey and rough looking ocean. I crossed the road, and made my way towards what I could only assume was an entrance to St Kilda beach.

When I reached the deck, a very long stretch of boardwalk extended to both my left and my right. In front of me, I was greeted by one of the flattest, gravelliest and dullest looking beaches I had ever seen. It was a miserable day, or course. But any West Australian would still tell you that this was not really a beach.

At the instruction of my iPhone, I veered left in search of the Pier. My Lost Highway jacket was flapping in the gale. I stopped, and tucked the umbrella in my hand underneath my right arm. I felt around for my FreeStyle Libre, mobile hotspot and digital camera in the pockets of my jacket, before tightly zipping it up.

I made my way past deserted cafes, fish and chip shops and kiosks, which I could only assume would be packed on a sunny Sunday afternoon. The wind only seemed to pick up even more as I reached the Pier, by which point I attempted to tighten the strap on my satchel. After a failed attempt, I decided that securing it against me with my right arm would likely be the best option.

The icy cold wind was whipping against my face, and I could feel the spray of the sea as the rough waves made their way across the pathway of the Pier. I could hear the constant whirring of the wind, a wind that makes you hope all the loose items in your backyard are fastened tight before a storm. I began running at one point, to avoid getting a drenching from the waves. Well, I minimised the drenching, at least. 

This was the most miserable day one could ever imagine.

Yet it was oddly exhilarating, too. 

For the first time in a long time, I wasn’t stressing over work. I wasn’t thinking about all of the things that I need to do, but haven’t done yet. I wasn’t exhaling my exhaustion loudly, like I normally do. I wasn’t looking at my phone. I wasn’t thinking about my diabetes, either.

As I stood at the end of the Pier, drinking in the sights and trying to snap photos without letting my camera fly away, I didn’t have a worry in the world.

For the sake of disclosure, Medtronic Diabetes Australia flew me from Perth to Melbourne to attend Diabetes Advocates Day on Saturday. I decided to stay in Melbourne for a few additional days at my own expense.