Friday, January 25, 2013

What I Learned...and Didn't Learn

I had an appointment at the Diabetes Centre yesterday. Sometimes my appointments are with my Diabetes Doctor, other times they are with a nurse and a dietician. I go because I have to go to three appointments per year in order to qualify for government funding for my insulin pump supplies. I also go because I like the opportunity to ask questions and, sometimes, get answers. And then there's always the dreaded A1C test results...

Yesterday's appointment was with a nurse and a dietician so there were no blood test results on the agenda. That will happen when I go back in March for my doctor visit. 

My goals with this appointment were:
- to have them sign and submit the annual renewal form for the funding for my pump supplies,
- to learn what I should do when traveling to Israel in terms of adjusting to the time change, and
- to give them my one-page profile that I had developed last weekend.

The annual renewal form was easy. I handed it to them, they filled it out and will give it to my Doctor to sign. They will submit it for me. 

The time change questions got a little more complicated. I understand, in theory, what to do. Once I arrive at my destination, I change the time on my insulin pump to reflect the current time in Tel Aviv. That's pretty much it and that will ensure that I receive the correct basal rates and bolus doses at the correct times. 

The problem, as I see it, is how does my body know that it's now on Tel Aviv time? Will it take a few days for my body to adjust to the new location and for things like the dawn phenomenon to happen at the correct time? If so, what happens during the adjustment period? Do I have highs and lows at odd times because the basal rates are on Tel Aviv time but my body is still on Canada time? 

"That's a very good question" was the response I got. 

Yes, I think so too. And the answer...? 

We talked about it for a while and the message was that I should test more often for a few days until things settle. 

"I am landing on the 12th at 2pm" I said "and I am running a half marathon on the 15th at 7:30am. That gives me 2 1/2 days to figure things out."

"Set an alarm to wake up during the night and test. Test a lot during the day. You should be fairly adjusted by your race."

They also gave me the name of a local Medtronic rep to call. Apparently he really knows a lot about pump settings. 

My problem is that I understand what to do with my pump - I just don't know what my body is going to do with the time change. That's not a pump thing - that's a diabetes thing. 

Anyway, I'll call this gentlemen from Medtronic and hopefully he'll have some more helpful advice. 

I know a lot of you bloggers and blog readers out there are avid travellers. Any tips for navigating time zones on the pump? I'd appreciate your insight...

Finally, I explained that I had created a one-page profile so that anyone who is supporting me will know a bit about who I am, what is important to me and how to support me. I wasn't sure what kind of reaction I expected but I did think that it was a pretty neat resource for them to have and I (secretly) hoped they might see the value of learning about each patient as a person rather than a patient. 

Person-centred medical support instead of making everyone fit into a similar treatment plan.  

Well, they seemed to think it was interesting and they put it in my file but that's about it. 

Perhaps it will grow on them as they continue to meet with me? Maybe a new person who is about to meet with me for the first time will open my file, read it, and be thrilled to know a bit more about me than my last A1C result and my diagnosis date. I hope so. I do think it's a pretty amazing tool if people take time to use it. 

1 comment:

  1. When I travel (mind you, it's always been within the US, so far) my routine is so nonexistent that things are always pretty wacky. As if my body doesn't even know what time to dawn phenom (hat -tip to Insulindependence) itself.

    One smart gal I know actually takes her total daily basal dose and splits it up equally across the board when she travels. I'm not that brave yet, but can see where it works for her.

    Unfortunately, there are so many variables to deal with when traveling. Wish I had some more solid information to share with you.