Managing sugar on vacation and your partner’s expectations

Type 1 and LADA
1

I am a type 1 and will be going on an active (for me, at least) vacation with some easy hikes and things like that.

Managing my sugar on these vacations can be a challenge, as you all know. Sometimes I feel a bit exhausted (mentally) and like I have to reign in my partner from her expectations.

I get very anxious driving multiple hours to said vacation spot, walking a couple miles, going to areas that are off the beaten path, etc.

But I feel that she (despite being my longtime partner) has high expectations. I feel the burden of being the tour guide/leader as the guy in the relationship and don’t quite know how to put into words that it would be great if we can have some slow paced time this vacation because of my concerns.

How do y’all think the best way to approach this is without being boring, or stick-in-the-muddy?

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I have a lot of business partners around the world and oftentimes I can explain to them that no, I can’t eat so and so because it drives up my blood sugar or no, I can’t run up the mountain because my blood sugar will drop too fast and nothing I say seems to sink in. They tell me I look fine and will not have any issues.

What I have found always works in these situations is to tighten up the alarms on my CGM. These people don’t react to a word you tell them no matter how well you know them and they know you, but boy do they react fast when an alarm goes off and you just calmly tell them you are having issues with your blood. All of a sudden they become very curious and reasonably pliable. Just a small trick I learned years ago to get even the most stubborn individuals in line especially in Asian countries such as India and China. The CGM alarm becomes your best friend and is reacted to by all people of all cultures and languages.

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Ive been married to a non T1 for 43 years. My advice, be honest. Look if she dont like the T1 outcomes she will never like you. You can change lots of things, you cant change that.

Give her some credit, I bet she likes you enough to be tolerant, and oh be sure you like her enough to let her know you are vulnerable.

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It is hard knowing where the line is between what we are capable of and where it is simply anxiety or i’m being unreasonable.

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It’s tough. i’ve learned over time—closing in on 40 years—that everyone sees this stuff through their own lens, not yours. Even my wife, who has been with me through that whole journey, from way back when to today, through 3-4 different treatment regimens. They really don’t get it! It’s weird, because you’d think after all that time… but then it’s not really that weird, because they can’t live in your body, they have no conception except by analogy to sicknesses they’ve had, and so they kinda go with if you look ok, you are ok, and have no conception of how easily the trap door can open underneath you with no warning, and how you need to THINK about that in advance and try to control or avoid the circumstances that might cause it to happen, based on past experience, and how hard it is to predict. They live in their body, not yours, and so they just don’t have any basis for realizing what it means. It’s funny because there are so many bad TV and movie plots around this stuff—Diabetic? Those guys have to take shots or they pass out!—that you’d think they’d have some concept, especially people who are close to you, who you’ve talked to about it. But I run into this all the time among friends and relatives, with only one or two exceptions.

Part of it is the nature of the treatment, I think. “Well, you’ve got that insulin stuff, that makes you better right?” Because that’s how medication works: you take it to make you better. But in our case, yah, kinda sorta, but it’s also a huge problem at times. It can make you worse, all of a sudden—that’s way more frequently and scarily the problem than running high for a while. But that doesn’t fit the profile of how other medications work in most peoples’ experience.

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So well put, and so true, sigh.

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Yes, exactly. You have to try to predict, and you have some information you can use to do that, but if you’ve had it any amount of time you know how often your predictions come up snake eyes. So you do your best. But it’s really hard to communicate that unpredictability and why you’re trying to minimize the variables, even to people close to you. Worst for me is that you set everything up for a certain circumstance, and then plans change. “Oops, we’re not having corn on the cob after all honey.” Oh, great, because I just took a great walloping bolus on the assumption that we were. This stuff happens all the time! And yeah, you can deal with it, you get used to dealing with it, but it’s still a problem that other people don’t grasp, even people who are close to you. You have to get used to that too.

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I have been married 28 years. I know what you are talking about, however I am the one who pushes to do more most of the time. There are several facets to the problems you are having.
There is the feeling of being safe with your diabetes and also expectations of leading something you barely feel like doing.
What I have done is set up some proctored or guided hikes and trips.
The guides will have emergency supplies and likely know how to deal with diabetics. You can ask that before you sign up.
But also someone else is handling the sights and the mundane tasks.
You can both just enjoy it together

You can tell her , hey I’m A little stressed about all the details of my diabetes on top of details of excursions, do you mind if we do some guided stuff.

It’s not just reasonable, but it is also so much more relaxing and fewer arguments, if she’s unhappy with it she Be unhappy with the guide and not you.

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Yes!!! Especially the part about “barely feel like doing”

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@Christoph:

You have already gotten some excellent advise, but I’ll give you my approach to these situations My vacations often involve scuba diving, hiking, or XC skiing … all light to moderate … but typically in remote areas. Here are the things I do:

  1. I’ve got backups for my backups … snacks, batteries, meter, glucagon, infusions sets, insulin …

  2. Through a combination of eating and reduced basal, I try to “run high”. Not crazy high, but comfortably high. A serious low can ruin the whole day!!! I’m on vacation and I try not to think my TIR is going to be terrible this week … this is one time when, in my view, you don’t want to be overly well controlled.

  3. And if my numbers are wonky or I just don’t feel right, I “sit one out”.

Best of luck and stay safe.

John

P.s. I really like @cj114 idea of tinkering with CGM alarms for both extra safety margin and “social” impacts.

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11

Thank you

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Could you frame the vacation as follows (to add to the excitement and adventure)?

We are going into the middle of nowhere during the largest healthcare crisis of our time. I do not want to be a burden or a stick in the mud, but nor do I want to pretend that everything is normal. My concerns are grave. 40% of the deaths during this pandemic were diabetics and I have a lot of extra burdens and concerns during this time that you might not be aware of. It is my ultimate goal not to cause you a bunch of grief, hardship, and heartache during this time by ensuring that I come out the other side unharmed.

When we go adventuring, we are a team. We are responsible for one another’s safety. We need to form a team that one another can trust and rely on. We need to be watching one another and reading in between the lines. If I get hurt or sick, then I will be no use to you. If you get hurt or sick, you will not be able to help me. Therefore, my ultimate goal is that no one gets hurt or sick during this outing. If I don’t ‘feel right’ about something, then I am not going to do it because that will put us both at risk.

I am female and tend, like Timothy, to be the ‘pusher.’ I lean a little manic in energy level and desire for external stimulus. I have heard ‘no’ many, many times from my partner, but always trusted his judgement. He would look me straight in the eyes, hold the stare, and simply, dryly say, “Your drive for fun is killing me. I can’t handle this much fun. If we have any more fun, I am going to die.”

Start joking about it with her. Tell her that her idea of fun is like getting sprayed with a fire hose of fun - one needs to catch ones breath eventually. Make it a joke - you can tease her about who she is, lovingly. She will get it and be able to adapt, unless she’s got some underlying OCD or control issues that makes it impossible for her to alter her behavior. I have family like that and I just have to limit the time/activities I do with them because the have personality ‘stuff’ that will always take precedence over my physical well being and ability to care for myself. It should be a warning sign if people and their ‘personalities’ are exercising undue control or encroaching on basic functions like your ability to eat, sleep, and use the bathroom. (I’ve had employers encroach there, too). That’s my line in the sand. Thou shall not cross, or we are gonna have conflict. No ones ‘personality’ is so important that I need to die to accommodate it. That’s a personality that is too big and needs to be reigned in.

Here’s some songs about the ‘pusher’ man, or woman, for your journey. Best hopes for ya’. Always remember that the ‘the pusher’ can kill ya’. Exercise good judgement and advocate for yourself.

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If you wish to know, you will need to test it. Recall when you tired really hard not to fart in front of her? Well eventually that idea goes away. A person just has to fart.

Same with diabetes.

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Here’s what I do although I am in my 38th year of happy marriage so I “hold no punches” in my spousal communications. Might be more touchy for others. We take a lot of active trips with intermingled long drives, camping, hiking, occasional hotels which all bring a lot of unpredictability.

First of all we always take extra time for meals which gives me a little time to think about how my BG control is doing, how to bolus for that meal etc. Even if we are on the road eating brown bag lunch, we stop somewhere, get out of the van, stretch our legs at mealtime. I get no objections for taking my time before the meal to slow down and think about what is happening with my BG and bolus accordingly. And we try to stick to a regular meal schedule so there are no BG issues from delayed or skipped meals.

Second of all I insist on knowing “what we will be doing” for at least the next few hours after that meal so I can adjust my bolus if needed, set temp basals or find/pack extra snacks, etc. So we talk about it and come up with a plan.

Third thing that helps is I bring an excessive amount of spare everything, including enough snacks, glucose, protein bars, drinks, what have you. This prevents the emergency stops at a pharmacy, store or gas station to buy things. Those emergency shopping trips when we are supposed to be vacationing are probably the only diabetes thing that bothers my wife so I try to avoid them.

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I’ve been married a long time and my husband is 95% of the time great with my diabetes. But I don’t think someone truly gets it unless they are a type 1 too.

Have you tried talking to her about what you want? While sometimes you think they should know, they really don’t sometimes. Maybe just say to her I would like less walking time so I don’t have to worry about my BG levels as much. And down time after a long car ride or more stops would be nicer.

When I’m on my exercise bike he just rolls his eyes when I get an alarm and I get off.
But I also snorkel with him. And he knew the work that went into figuring out how long I could stay out safely. He’ s even the one that got an underwater watch to keep track of the time we are out there.

I say 95%, because they really don’t understand it the same way we do. He knows the ocean was tricky figuring out and he will ask me after we have been swimming for a while if I am doing okay. And yet the first time I went by myself (there is a lifeguard on the beaches I go to when I’m alone) he didn’t blink, for me that was a huge deal. He totally didn’t think anything about it. Me I’m saying to myself this is a huge deal, I want to try this and get past this. I want to know I can.

So sometimes they really just don’t completely understand. Personally I think they see us dealing with it, they know what we do and we deal with it. I think there becomes an expectation that we will speak up about something if we need something.

So she might be oblivious that you don’t like handling it the way you have been…but there are many personalities out there and people can be so different.

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