Whenever Nancy and Buford Crook pull their 41-foot RV out of the driveway for another long road trip, there's something they both never leave their Kansas home without — diabetes. So along with enough clothing, food, maps and other travel essentials, they pack their diabetes medications, blood glucose monitors, snacks and walking shoes — plus a firm determination that they won't let diabetes slow them down. "It's always a concern in the back of our minds," Nancy says of type 2 diabetes, which she and Buford both have, "but we don't change our travel plans because of it."
In fact, planning ahead, eating right and staying physically active when you're on the road can make traveling with diabetes a routine experience. Whether you're RVing for weeks at a time, flying overseas for that dream vacation or just hopping in the car for a weekend getaway, diabetes need not be a problem.
The Crooks certainly don't let it cramp their style. Last spring, the retired couple and their two Siamese cats happily motored from Kansas to Shawnee, Okla., then to Abilene, Texas, on to Shreveport, La., and then back home. Last fall, their mobile home-away-from-home took them to stops in Missouri, Arkansas, Oklahoma, Texas and Louisiana. "We put between 15,000 and 20,000 miles on the RV per year," Nancy says.
Besides their RV, the other thing that keeps the Crooks on the move is belonging to the Good Sam Club. The national organization's million-plus members are fellow RV enthusiasts who travel among the more than 1,700 Good Sam Parks in the U.S. and Canada. They also rally year-round, hundreds of rigs at a time, at multi-day extravaganzas known as "Samborees," organized throughout the U.S. by state directors, of which Nancy is one.
Whether you travel by car, plane, boat, bike or foot, keep a carry-on bag with your diabetes supplies and medications with you.
Stocking up on the oral diabetes medications they take twice a day has become a familiar packing procedure for the Crooks. "We bring separate daily pill-reminder boxes, different colored for morning and evening," Nancy says. They always pack an extra week's supply, just in case they're away longer than expected.
At home, the Crooks get regular exercise by walking, though it takes some resourcefulness on the road. "We walk around the RV parks," Nancy says, "and at Samborees we walk a lot when visiting friends and vendors."
Jean Goossen is the Good Sam Club's state director in Wisconsin. She and her husband, Dave, have been well-traveled RVers since 1985 — about two years before Jean's doctor recommended she switch from oral medications to insulin injections to better treat her diabetes. In 1991, she began using an insulin pump, which requires another type of preparation when taking one of their many RV excursions.
"I know how much insulin I'm going to use every day, so I just have to be sure to bring enough," says Goossen, who traveled most of this summer on club-related trips. She stores her insulin in the RV's refrigerator. (Insulin should be stored in a cool, dry place. It should never be stored in the freezer or on ice; doing so can make it less effective.)
That points to another aspect of traveling by RV, most of which are outfitted with complete kitchens. "We eat the majority of our meals in the RV," Goossen says, so she shops and cooks pretty much the same as she does at home. When they do eat out, she employs her "anywhere" restaurant strategy. "I have to know what I'm ordering and the number of carbohydrates, because that's how I monitor my insulin intake," she explains. When in doubt, Goossen refers to the copy of The Carbohydrate Addict's Carbohydrate Counter she always has with her.
Living well at home and away
While Jim Frcka has nearly 20 years of RVing experience, he's just beginning to appreciate what Goossen and the Crooks are talking about. "I was diagnosed with type 2 diabetes last year," he says.
But that wasn't the worst of what his doctor told him when Frcka went for a routine physical: "He laid the bomb on me that I also had cancer."
Frcka's cancer was successfully removed, and now he's managing his diabetes well, at home and away. "I take it very seriously as far as diet and exercise," he says. Although never terribly overweight, Frcka has lost 15 of the 20 pounds he wants to shed.
"I've always been a huge eater," he confesses, "so my No. 1 change has been portion control, as well as what goes on the plate. For example, instead of a greasy hamburger, I'll have a chef's salad. And by watching what I eat at home, I take those lessons with me when I'm on the road."
Frcka and his wife also take their two dogs in the RV, providing frequent opportunities for exercise. "The dogs have to be walked," says Frcka, the Good Sam Club's state director for Illinois, "so we make stops along the way to RV parks and then take long walks at the parks." All that walking, he adds, helps keep his blood glucose in check.
The Friendly Skies
Of course, people with diabetes travel by modes other than RVs, which can require different types of preparation. Peter Lanzer, a type 2 diabetes patient in Connecticut, has been a frequent flier for years, often jetting to overseas destinations. He always packs extra oral medications and test strips for his glucose monitor, and keeps everything in his carry-on bag, not wanting to risk losing luggage.
Lanzer also has learned to be diligent about avoiding hypoglycemia. "Things tend to get out of kilter when you're traveling," he observes, "so you have to make sure you don't miss a meal. And you have to watch what you eat, especially sugars and carbohydrates." The bottom line is, he admits, "you tend to live it up a little when on vacation, so you have to be doubly careful." Although the Transportation Security Administration allows multiple containers of liquids or gels (including Cake Mate® tubes), the American Diabetes Association suggests carrying an alternative form of carbohydrate such as glucose tablets, Life Savers®, gumdrops or raisins.
Going through airport security can be nerve-wracking for anyone, but especially for people with diabetes who are going through scanners with vials of insulin or bottles of prescription drugs that may be unfamiliar to inspectors. "I recommend to diabetes patients that they have the original packaging for all their supplies and prescription medicines in bottles with their doctor's name on them," says Dr. Karen E. Earle, medical director of the Center for Diabetes Services at California Pacific Medical Center in San Francisco.
The American Diabetes Association also suggests that patients have a letter from their doctor, explaining that they have diabetes and need certain medicines. "The letter that I write," Earle says, "explains that they must have access to their medications at all times. Then I list exactly what they need, such as insulin syringes and vials, pens or pumps. And I include my contact information in case someone has a question." In addition to the letter, Earle encourages her patients, particularly those with type 1 diabetes, to wear a medical bracelet or necklace. It's an easy way to let anyone know you have diabetes.
If you wear an insulin pump, you may choose to request a visual inspection rather than going through the metal detector or being hand-wanded, but you may be subject to a pat-down.
When you're journeying to a foreign country, you can obtain a list of English-speaking doctors beforehand from the International Association for Medical Assistance to Travellers (iamat.org; 716-754-4883). Once you've arrived at your destination, overseas or in the U.S., if a medical emergency arises, you can always go to an emergency room or clinic.
If you take insulin and will be crossing time zones, the American Diabetes Association recommends that you ask your doctor or diabetes educator to help you plan
the timing of injections.
What to Pack in Your Carry-On
Whether you travel by car, plane, boat, bike or foot, keep a carry-on bag with you at all times, packed with:
* All the insulin and syringes you will need for the trip
* Blood and urine testing supplies (include extra batteries for your glucose meter)
* All oral medications (an extra supply is a good idea)
* Other medications or medical supplies, such as glucagon, anti-diarrhea medication, antibiotic ointment and anti-nausea drugs
* Personal ID and diabetes identity card
* Well-wrapped, airtight snack pack of crackers or cheese, peanut butter, fruit, a juice box and some form of sugar (such as hard candy or glucose) to treat low blood glucose
* For insulin pump wearers: extra infusion sets and reservoirs/cartridges, the pump manual or an instruction sheet, and the telephone number of your health care provider or endocrinologist
in the event of an emergency
For more information about airport security and traveling with diabetes supplies, visit the Transportation Security Administration and the American Diabetes Association Web sites.
By Bob Woods. Photo of Nancy and Buford Crook by John Hubbard.