# 1st time abroad & with an insulin pump!



## Michael (Apr 30, 2012)

Hi,

I'm going on my very 1st trip abroad on 1st June this year to New York for 3 nights.

Please can anyone offer me some advice on traveling with all the equipment I'm going to need.

Will I be able to take Glucojuice onto the airplane, just incase I suffer a hypo?

What will I expect at customs in USA and UK?

Do I need any special medical insurance?

Sorry for all the questions. I'm really excited and nervous at the same time.

Thanks,
Michael


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## HOBIE (Apr 30, 2012)

Am jell !  I have been a few times with pump.  The first time i was exactly the same as you. (thinking bells would be ringing & swat team all over) I even dissconnected & put pump in hand luggage while going through metal detectors just in case.  NO PROBS & have a good time in the big app


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## m1dnc (Apr 30, 2012)

I'm overseas at the moment, after my first flight out of the UK with my pump.

I'm away for seven weeks so quite a lot of kit to pack.

First things first. I was told in no uncertain terms by my DSN that the pump itself, while powered up (i.e. with a battery in it) must NOT go through the hand baggage X-ray scanner. When I approached the security arch at the airport, I lifted up my jumper to show the security man that I was attached to my pump and he waved me through the arch - which then started bleeping. I was then given a manual pat-down and the pump was swabbed for explosives. This was all handled very calmly and politely by the security staff.

Meanwhile, my hand baggage with 7-weeks supply of insulin, cannulas, meter, test strips etc etc went through the X-ray scanner without problems.

I should say that I had another large carry-on bag with all the usual stuff in it. I was flying with Virgin and had previously checked that they would allow an extra carry on bag for passengers with medical needs. I did a bit of checking on the internet first and it seems that most airlines have the same policy.

I kept my insulin in the fridge until I was about to leave, and the first thing I did after arriving at my destination was to refrigerate it. Past experience (with my old insulin pens) has shown me that the insulin will be OK for my time away, if it is out of the fridge for this sort of time (my flight was 8 hours).

To be honest, the worst problem for travelling for me was to work out how much of every pill and bit of kit I need for the time away. I've worked on the principal of 50% extra of everything 'just in case', and a back-up of essential kit like your meter, cannula inserter etc.

I'm in a hot climate so I brought a Frio pump cooler with me, but I haven't used it yet. I haven't noticed any adverse effect of the heat on the insulin actually in the pump. I usually refill every 6 days.

Before I left I discussed everything with my DSN. One effect of the heat that I have noticed in the past is a reduced insulin requirement. We put a in a basal rate profile which is 20% lower than my normal profile. I switched to this a couple of days after my arrival as I was getting quite a few low BGs, and it seems to be working OK.

One last thing, I changed the time on my pump to the destination time (in my case -5 hours) as soon as I got on the plane. Oh, and don't forget to turn off Bluetooth on the pump and meter (if yours uses it), for the duration of the flight - you'll have to enter pump boluses manually in the air.

Bon voyages!


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## trophywench (Apr 30, 2012)

Insurance - you MUST have travel insurance before setting foot in America. Medical bills are phenomenally expensive.  And make sure the medical expenses section covers 'pre-existing conditions'.  Ours is 'free' with our bank account, and does.

If your PCT is like mine (and I think they all do this?) you had to promise to insure the pump itself as a condition of getting it, so check that the policy extends to include X number of days abroad.

Additionally, some pump companies offer you a loan pump to take on holiday 'just in case'.  Having said that you could probably manage for 3 days on syringes or whatever you take as back-up.

I haven't crossed any time zones since I had my pump so have no advice to offer on that spect, though I think there's a section in the handbook I had with my Roche one.

Finally if yours has Bluetooth, you have to turn that off on the plane so I'd have test my blood and let the meter work out the bolus, then tell the pump manually to deliver it rather than the meter signalling the pump to do it automtically.

Have a lovely time!


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## everydayupsanddowns (May 1, 2012)

Do you regular fliers on pumps (not had to cross that bridge yet) ever notice any goings-on with the pump and pressurised cabins? I';m sure i've read about that somewhere for medium/long-haul flights, but can't remember whether it was on a forum or in the pump manual.


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## trophywench (May 1, 2012)

Well I can tell you it wasn't the pump manual, because I've read that too - ages ago  - I think it can't be the manual because we have different pumps.

I would have thought you do the same as on MDI and change when you get there to local time immediately?  I know when we went to Oz,  we didn't have a stopover so were obviously travelling for 25 hours or something; 8 am-ish departure from Heathrow, changed planes in Kuala Lumpur, then to Sydney and changed again, final segment to Brisbane, where it was about 10.30 pm,  So I fire-fought with fast-acting all the journey, then did a correction when we got there, had my Lantus when we went to bed shortly thereafter and had a fab night's sleep, and just carried on as normal thereafter.  Easy coming back too as we had a stopover in KL.

So with the pump, I'd firefight with corrections and TBR's during the journey(s) and just err on the side of caution - like not bolusing before meals on the plane, as you never know if you are going to like whatever it is.


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## everydayupsanddowns (May 1, 2012)

It was something to do with pressure variation TW, rather than timing the switchover between basals. From what I understand (according to a quick scan of Wikipedia) cabin pressure varies during the course of the flight but is usually significantly different to 'sea level' - more like standing on a pretty high mountain.

I can't remember whether it was that you needed a +ve or -ve TBR, but there was deffo something about the pressure in the cabin slightly altering/affecting the micro-style basal deliveries through the cannula/tubing.

Sounds like you've not noticed though?


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## randomange (May 1, 2012)

everydayupsanddowns said:


> It was something to do with pressure variation TW, rather than timing the switchover between basals. From what I understand (according to a quick scan of Wikipedia) cabin pressure varies during the course of the flight but is usually significantly different to 'sea level' - more like standing on a pretty high mountain.
> 
> I can't remember whether it was that you needed a +ve or -ve TBR, but there was deffo something about the pressure in the cabin slightly altering/affecting the micro-style basal deliveries through the cannula/tubing.
> 
> Sounds like you've not noticed though?



I definitely need more insulin when I fly home - and that's only a one hour flight!  I was told it was to do with altitude increasing insulin resistance though, and it's a problem I've noticed both on MDI and on a pump.


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## Amanda102 (May 1, 2012)

We went to Florida during easter holidays with my T1 daughter who uses an omnipod pump so this was attached to her leg on way out and arm on way back.  On way out when she was in the 'arch' the security asked if she had something in her pocket.  When explained what it was it was swabbed for explosives (presumably) and that was that!  Quick and painless.  On the way back they never even asked about it!  We also had insulin vials, needles, pens, glucogel, spare pods etc in the hand luggage and this was never queried at all.  We had a letter ready from the hospital but it was never needed.  I had to notify our usual insurers of her diabetes and get my GP to send a letter saying she wasn't likely to need hospital treatment etc while abroad, but the cover was then valid at no extra cost.

Good luck and bon voyage!


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## m1dnc (May 1, 2012)

everydayupsanddowns said:


> Do you regular fliers on pumps (not had to cross that bridge yet) ever notice any goings-on with the pump and pressurised cabins? I';m sure i've read about that somewhere for medium/long-haul flights, but can't remember whether it was on a forum or in the pump manual.



I didn't notice any effect of pressure, though it did occur to me that it might be a problem. (Have you noticed the effect on empty water bottles when the 'plane is coming in to land.)



trophywench said:


> Well I can tell you it wasn't the pump manual, because I've read that too - ages ago  - I think it can't be the manual because we have different pumps.
> 
> I would have thought you do the same as on MDI and change when you get there to local time immediately?  I know when we went to Oz,  we didn't have a stopover so were obviously travelling for 25 hours or something; 8 am-ish departure from Heathrow, changed planes in Kuala Lumpur, then to Sydney and changed again, final segment to Brisbane, where it was about 10.30 pm,  So I fire-fought with fast-acting all the journey, then did a correction when we got there, had my Lantus when we went to bed shortly thereafter and had a fab night's sleep, and just carried on as normal thereafter.  Easy coming back too as we had a stopover in KL.
> 
> So with the pump, I'd firefight with corrections and TBR's during the journey(s) and just err on the side of caution - like not bolusing before meals on the plane, as you never know if you are going to like whatever it is.



As I said in my earlier post, I changed my time settings as soon as I boarded, but then my flight was relatively short (8 hours) and the time zone difference not that great (5 hours). Also I left about 9-ish in the morning and arrived here just after lunchtime, so the travelling day was effectively a long day. I'd have to think again harder for a long trip downunder. I think the Roche manual says that you should move the time settings for basals by 4 hours at first (for more than a 4 hour time difference) and then an hour a day until you've caught up with local time.

I left my basal alone for the journey. I believe that some people have to TBR when flying, but I wanted to see the effect. I've done a lot of flying over the years so I don't get stressed, and perhaps that's the reason. I tested frequently and bolused normally whenever I had anything to eat. I don't recall any corrections


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## Michael (May 1, 2012)

Thank you so much for the support and telling me your experiences, I really appreciate it!

Keep them coming!

Michael


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## spiritfree (May 1, 2012)

Michael, I am also flying for the 1st time with a pump. Infact I have never flown at all. I have taken out insurance for al existing illnesses. I had to tell them every bit of my medical past, from stroke to sleep aponea and type 1 diabetes and loads more, but at least I am sure they know all about me and can't wriggle out of anything if something goes wrong. There are a few insurances that take people with type 1 diabetes and many other illnesses. I am also going to try to hire a spare pump, incase mine plays up.


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## HOBIE (May 2, 2012)

Have a GOOD time !  You prob use more insulin cos you are sitting doing nothing but i have never came across any pressure probs what so ever ENJOY


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## Phil65 (May 3, 2012)

everydayupsanddowns said:


> It was something to do with pressure variation TW, rather than timing the switchover between basals. From what I understand (according to a quick scan of Wikipedia) cabin pressure varies during the course of the flight but is usually significantly different to 'sea level' - more like standing on a pretty high mountain.
> 
> I can't remember whether it was that you needed a +ve or -ve TBR, but there was deffo something about the pressure in the cabin slightly altering/affecting the micro-style basal deliveries through the cannula/tubing.
> 
> Sounds like you've not noticed though?



Hi Mike, I notice a difference with the cabin pressure definitely affecting my insulin resistance.  Any flight of longer than 1 hour I TBR 200% seems to work for me.


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## rachelha (May 3, 2012)

I am flying for the first time with a pump tomorrow.  It will also be the first flight with my toddler - eek.  I can't find an up to date letter about taking supplies on the plane.  I only have one relating to MDI and with my maiden name on it.


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## Northerner (May 3, 2012)

rachelha said:


> I am flying for the first time with a pump tomorrow.  It will also be the first flight with my toddler - eek.  I can't find an up to date letter about taking supplies on the plane.  I only have one relating to MDI and with my maiden name on it.



I'm sure you'll be fine Rachel - I hope all goes smoothly for you


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## Monica (May 3, 2012)

Have fun on your holidays!!!
Just want to mention ONE thing - at Manchester Airport (don't know about London), they have a new X-ray machine for people. As the pump isn't allowed through X-ray, make sure you tell them that fact and that you need to take your pump off first.
I had a bad experience with it, as I told security that *my daughter* couldn't go through that machine and they made a huge fuss, telling me that if she doesn't go through, then she doesn't fly  All the while other people just walked past this X-ray. Had I said the pump can't go through, I'm sure it would have been fine.


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## Mel (May 5, 2012)

We have a letter from the DSN saying we need emergancy supplies in hand luggage and insulin should not go inthe hold 
The pump companies will lend you a pump I put ours on the house insurance telling them its a spare pump and how long we will be away.
Been to the states several times and no problems just told them we had needles etc in hand luggage for T1, they never questin the amount of liquid as she is diabetic


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