Flying High While Chasing the Sun

   Earlier this month, I arrived back home to Canada after a 30 hour flight from Singapore.  I’d had a working / holiday  in Asia for the month of December that had started off in Tokyo, and couldn’t ask for a better holiday with the various countries we explored along the way while cruising  the high seas on the Diamond Princess (and discovering that some of what we take for granted as diabetics here with gadgets, etc.  is unheard of in many of the countries I visited - we are very spoiled!!).

   When I'd originally flown out earlier in December to Tokyo, I had worn my Animas Ping insulin pump after reading a comment on Facebook advising against wearing it when flying.  I've gone back to find that post since seeing it back in November before I departed , but you know Facebook, lots of action in these groups we belong to, and you need a lot of time/patience to search posts at time, and so far, I’ve had no luck.

   Fast forward to our rather turbulent flights at the end of the December to bring us back home.  Early 4 AM (ugh!) start to head to Changi Airport in Singapore (the most beautiful airport I've ever been and below is a little video at this link  I made with fishies in the Enchanted Garden). 

   The 6 hour flight to Tokyo I slept the majority of it, in-between my last bits of yummy food service on the flight.  Blood sugars were doing fine just like they had done throughout the whole month when I was on the Omnipod.  When we were approaching Narita Airport we heard the engines accelerated as the plane pulled up to a higher altitude to avoid either an ongoing plane (or a drone LOL?).  The plane landed and as usual we let all the folks in a rush get off with us being the last.  I noticed my water bottle that had been emptied earlier, sucked in pretty flat.  It’s not unusual for that to happen, but it was something that came to my mind later on when problems started to occur in the 2nd leg of our journey home. 

   Narita is a big airport, so with the 3 hour layover before our next flight, I got to use up the rest of our Yen walking around and getting some much needed leg stretching.  Of course, this kept  Sock Monkey amused as you can see below.  I’d noticed my Dexcom G4 that my trend arrow was straight but my blood sugars seemed to be rising with the alarm/vibrations going off.  No big concern to most of us, simple correction bolus, and all was good (or so I thought).  At this point in time, I still had a days’ worth of insulin left in the Pod, which I’d calculated would last out until the Pod needing changing when we got home to Canada.

   The next leg of our trip was  a 13 hour flight,  I realised something was up.  Corrections didn’t seem to be doing anything and trend line though still straight was showing blood sugars on the rise. Fiasp to the rescue though  I was worried about  the risk of stacking insulin at this point in and maybe going low fast.  The strange thing was that the Omnipod PDM at this point hadn’t alarmed of an Occlusion or possible problem with the Pod.  Confirming blood sugars with a meter to see if my CGM was off track, proved it was pretty well spot on.  I can’t say enough about how valuable a CGM is to a diabetic on insulin!!

25 mmol/l or 450 mg/dl

   We informed the Air Canada flight crew at this point in time that even with the turbulent air that we had most of the flight, that I was having some serious health issues and needed a safe space (not the cramped loo) to do some medical change outs and also to be prepared in case I crashed low .  Due to majority of folks on this long journey sleeping, with our mini flash light in our mouths, we pulled out my medical kit bag and proceeded to remove the Pod which when we looked at the site, it seemed dry as a bone.  This is unusual as usually you see either a drop of insulin and/or blood at the site where cannula is inserted and/or on the cannula.  Also, the cannula of the Pod wasn’t kinked, so obviously that wasn’t the problem.  My hubby Mike assisted me especially with the turbulent flight, and in less than 20 minutes, the Animas Ping was back up and running! Let’s just say the crew of Air Canada was very sweet in allowing me to take over a busy area and at the same time, they learned abit about insulin pumping and Type 1 diabetes.  Yuppers, that’s me, always the educator!

Back on my juice of life with the Animas Ping

   The waiting game started, and with the Fiasp in me, basal insulin working, within 3 hours, I was seeing my trend line going back to my happy zone that I like to keep myself.  I managed to nod off at that point (I was freaking out of course with what was happening earlier), but still being on high alert, it was a pretty crappy sleep even sitting in the Premium Economy that we managed to snag for a few extra bucks for this long flight home (personally, it’s not worth it, but we gave it a try, I prefer cattle class).

  Our conclusion of what we think may have happened - remember that water bottle above?  I found out from a long time Omnipod user that the reservoir that holds the insulin is a bladder, so unlike my Animas cartridge that is solid plastic, this one is flexible.  That could explain perhaps why the insulin was not being infused into the skin if the bladder had sucked itself in.  I had looked over the manual while on flight, to see if there was any mention of this, but there’s nothing stating that this could be a potential hazard.  I’ve talked to a few other Omnipod users, who do frequent long distance flying, it’s never occurred to them. So I’m a freak of nature.

   I dutifully reported what happened to Omnipod Canada (my first time calling Customer Service, and despite what Americans have said about them, which isn’t the greatest, I had absolutely no issues).  I did tell them that I was surprised that in the manual that there is no mention of this potential problem.  Having this at least mentioned as a potential problem would be a good thing to have in the manual, just in case.  The fact that not all insulin pumpers have the ability to afford a CGM that does keep you aware (if you have alarms set properly, etc. etc.) then it could be a potential problem.

   Meanwhile, to be on the safe side, I’ve reported this incidence to FDA and am still trying to figure out how to report it to Health Canada (it’s like looking for a needle in the haystack to find the area unlike the FDA that is very user friendly).  

   Yes, I’m still enjoying using the Omnipod, don’t get me wrong, but at least I’m now aware of a potential problem and will be more prepared, or wearing a tube pump,  and/or MDI to ensure I stay in my happy zone of blood sugar control when I'm flying or experiencing frequent air pressure changes!  Flying should be stress free!!!