By: Amy Powell
Students in the healthcare field have probably attended a “bugs and drugs” lecture about bacteria and the various antibiotics used in response. Put that on a whole new level, where the “bugs and drugs” are hordes of mosquitoes and peculiar plants, and you would be envisioning my pharmacy rotation in the Peruvian Amazon rainforest. The purpose of the trip was to study medicinal plants and natural medicine, but our group definitely braved the elements as well. A few of the pleasures we got to experience included extreme heat, daily paddling of canoes down the Amazon River, tightly rationed drinking water, bathing with piranhas, stepping in quicksand, eating guinea pig, and almost sinking our canoe in a torrential downpour. Now mix in my diabetes, and you would seemingly have the recipe for the perfect storm.
Fortunately, this was not the first trip that I’ve taken out of the country. I knew that I had to be extremely careful and ultra-prepared for the teeter-totter of high and low blood sugars every day. I use an insulin pump and carried at least double the necessary supplies. All my camping gear, clothing, and supplies for three-and-a-half weeks had to fit in my hiking backpack and a normal backpack that was solely devoted to my diabetes supplies. I’m grateful there were laundromats; otherwise, I might have become the social outcast of the group!
The most rustic portion of our trip was a three-day journey down the Amazon River in canoes, three man-powered and one motorized. At night, we camped in tents along the bank of the river. Needless to say, toilets were nonexistent in areas, and showers were out of the question. Healthcare providers would cringe, but I kept a bottle of insulin with me at tropical temperatures during this portion of the trip. I did my best to store the vial in the shadows to keep it as cool as possible, but I also had to keep my bag away from the ever-rising water in our waterlogged canoe. There are special cooling kits on the market for camping, but I did not have one.
Meal times were also extremely variable, and sometimes absent, but I always had some form of carbohydrate that served to combat both low blood sugars and hunger pangs. Even when meals were timely, I had no idea of exactly what I was eating. My speculations for insulin boluses were never spot-on, but they were decent enough.
On the final day of our three-day journey, our group boarded a speedboat to go back upstream to our reserve. It should have been a three-hour trip at most. Unfortunately, due to debris from recent flooding and a malfunctioning motor, we were delayed on the river for about eight hours. We had not eaten anything all day, had very little water, and had not been able to use a restroom (unless you wanted to go over the side of the boat).
Because it was the end of our camping excursion, I only had one granola bar left. I held out as long as possible, but hunger got the best of me and I ate it. I figured I still had my glucagon injection if absolutely necessary, but thankfully, no one had to use it on me.
After the taxing journey in the heat of the Amazon, we spent one week in the cold, mountainous region of Cusco, Peru. We went from 100-degree highs to 38-degree lows in a matter of a one-hour plane ride. Our bodies also had to adjust to the lack of oxygen at the high altitude. After a day of rest, we were just as active as in the rainforest, exploring the ruins of Cusco and Macchu Picchu. I was better prepared to counter my high activity level by lowering my basal rate to prevent low blood sugars.
If you have diabetes, don’t be discouraged from traveling! If you are a healthcare provider, equip your patients with the proper tools to allow them to explore this beautiful world. I have learned a lot from trial and error, but there are plenty of resources available for traveling safely with diabetes. These experiences have taught me volumes about myself and others. It is a wonderful opportunity to fall in love with a new culture and to reevaluate your world view. With diabetes-and let’s be honest-even without it, organization and preparation are necessary for travel, but it is time well spent.
If you are interested in further details about my experience, you can read my blog at www.pharmingtheglobe.blogspot.com. While you are online, go book yourself an adventure!