Being unlimited in countries with poor medical infrastructure

I agree. As I said before, planning is the key.

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Well, when youā€™re sick but have a bad stomach bug, you may need a lot of insulin to keep ketones at bay but because your body is not digesting carbs you canā€™t raise your blood sugar with low treatments. And once youā€™ve gone long enough without eating, giving yourself glucagon wonā€™t do anything for raising your blood sugar. DKA can also come on quickly if youā€™re getting dehydrated. So I imagine youā€™d use it for IV fluids with some dextrose in it.

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I think this sums it up well - we all have our own definition of unlimited based on our personal situation - experiences, lifestyle, and especially other health issues. Iā€™m another with several health issues that ā€œlimitedā€ me prior to being diagnosed with LADA, in that I canā€™t do certain things or I choose not to do/to do certain things that others who donā€™t have the same health issues cannot fully understand. In fact, Iā€™ve had someone close to me tell my husband in response to something we were choosing not to do that we ā€œshouldnā€™t put our life on holdā€ and choose not to do this one thing because of my health issues. I didnā€™t (and still donā€™t) consider it putting my life on hold. Not choosing to do that allowed me to have the ability to do many other things (and avoid a potential hospital stay). I was not limiting myself but living unlimited in the unique way I can based on my life circumstances. Thereā€™s no right or wrong way to be unlimited.

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It should have been obvious that the top post was referring to DKA risks, but I missed that. Your explanation is clear, thanks.

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So what are we even disagreeing on?

I think everyone here agrees on planning being vitally important to being successful.

I actually hesitated before writing, ā€œThere are some things I canā€™t do.ā€ But I did, because there are things I canā€™t do. And I think recognizing what I canā€™t do has been really important in the ability to plan for ways around those things so that I can still accomplish my goals.

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I was going to say something about being prepared with contact info for English-speaking doctors wherever youā€™re going. There may well be hospitals, or community clinics in smaller places, but staff may not speak English that well or at all, and in a medical crisis, clear communication is imperative. We always prepare with these lists, getting the info online (which can be outdated) or from embassies and consulates. But then while researching something else I found this organization, which Iā€™d never heard of before. Membership is free, and provides a listing of fluent English-speaking doctors around the world. Could be useful for some people.
https://www.iamat.org/member-benefits

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Here are my views on planning, summed up in a single image.

Iā€™ve never ā€œplannedā€ anything in my life that ended up being remotely close to how I planned it. So, Iā€™ve finally learned to live in the moment as much as possible and figure things out on the fly. I like the challenge of figuring things out on the spot. :slight_smile:

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I have avoided wading into this fray until nowā€¦but will add an anecdote which is unrelated to toddlers, but is related to traveling to India.

Two years after being diagnosed with T1 Eric and I traveled to India together for over a month. I think, for me, it defined the ideas that would form the rest of our lives living with T1 - the disease is ancillary to the living of our life. We traveled around the country by various means of transportation, further than most of our Indian friends had ever gone, staying in lodgings ranging from $2 a night to $100 a night. We used the Frio packs despite the humidity and didnā€™t sweat it. We had back up supplies, but not a lot. During this trip, Eric began to suffer from substantial G.I. issues. It never occurred to us to worry about diabetes, truthfully weā€™d probably not heard of DKA, and we didnā€™t carry ketone strips or IV fluids, he just kept doing fingersticks and injecting Lantus and Humalog, despite the GI stuff. In the middle of the night in Jaipur we walked to a hospital across the street from our hotel. I was concerned about cleanliness, the ability to communicate with the doctor, and so forth. However, the experience was excellent. This was not a cutting-edge medical facility, but the doctor spoke excellent English and was incredibly helpful. For about $35 US Eric received thoughtful treatment, got both antibiotics and probiotics, oral rehydration salts, and was back in bed in the hotel across the street in under an hour. Sure, this wasnā€™t a life threatening emergency. But the health care across India has been surprisingly good when weā€™ve needed it as visitors (weā€™ve been twice, Ericā€™s been to an ER both times, and we look forward to going again).

I donā€™t ever want to deter anyone from their personally enjoyable methods of planning that leads to their own reduction of stress. I like planning! However, I do want it to be on the record that crazy travel, even with illness or unexpected situations, can work out well.

(P.S. Eric lost his Dexcom receiver on our second stop of a month long work trip around the world last year. Thanks to our previous extensive, probably under-planned, travels across India - this loss wasnā€™t an issue. He simply reverted to fingersticks and continued to the next seven countries and enjoyed himself, despite not having the minute-by-minute traces the Dex wouldā€™ve provided. It worked out fine. And happily the receiver was shipped back to our home in the US, even though it took the hotel forever to find it and we got home a month before it did!)

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Cool description of your adventures and misadventures! Your reference to a $2 flophouse stirs the imagination! :open_mouth:

This Sentence was funny!

EH, do you know that Kim is looking forward to you going back to an ER in India?! Maybe you should leave her in the U.S. on your next tripā€¦
:rofl:

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Ha! I guess it was! Iā€™m not really looking forward to another emergency room visit, but the ones in India have actually been quite good. I was so impressed by the probiotics and antibiotics prescription, this was in 2005 and nobody in America was prescribing both at once. Also, all the medication was dispensed at the hospital ā€“ we didnā€™t have to drive across town to a 24 hour pharmacy, we have to stop by the front desk on the way out!

On a completely unrelated note: turns out, Eric is actually allergic to DEET insect repellant. Due to possible side effects, we didnā€™t take the anti-malaria meds, and instead used a pretty regular supply of mosquito repellent while in India. Turns out, it makes Eric vomit. Probably also had food poisoning, but the continual vomiting was from the mosquito repellent. Until this moment, we thought that he just had really good blood glucose control while he was in India because there were less processed foods, but it has occurred to me maybe he just ran way lower because he was puking all the time. :rofl: :thinking:

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Is he allergic to DEET because it travels through the skin and has systemic effects, or does he have contact issues with DEET.

If it is because it absorbs, there is an amazing product from 3M called Ultrathon, that attaches the DEET molecule to a huge polymer so it canā€™t be absorbed through the skin. This means that the DEET lasts longer between applications and is much safer to use.

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I actually like Indian doctors for diagnosis ā€“ they have seen everything so the relatively routine illnesses western travelers come up with donā€™t phase them and they often will come to your house to examine you. And you can pick up antibiotics/etc. at pretty much any drug store for minor things. But I donā€™t trust the hospitals there at all. And I think ultimately, taking care of sick toddlers in India sounds NO FUN even if in the end nothing is dangerous. Iā€™ve never ever gone to India and not gotten sick, so I would assume that one or both kids would be sick.

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picaradin is VASTLY superior imo anyway, you have to look a lot harder to find it, but once you try it yo never want anything to do with DEET

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Got bugs?

https://www.amazon.com/Sawyer-Products-SP564-Repellent-Picaridin/dp/B01LVV7MU3/

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He is sensitive to the DEET from a systemic/absorption perspective. He puts it onto his skin, gets naseuos immediately, if he runs or itā€™s really hot and he gets sweaty, he then vomits. (Iā€™m sorry to have incorrectly used the word allergy, as itā€™s not anaphylaxis, but it really screws him up.) Took us a while to figure this out, but weā€™ve tested it with a variety of DEET products (spray, cream, etc.) and all cause it.

I will read about the Ultrathon! Sounds amazing. Thanks for sharing. And thanks, @Sam for the picaradin suggestion. I will keep my eye peeled for it. I assume Alaska has mosquitos as big as helicopters! :helicopter:

@TiaG I was thinking I probably wouldnā€™t want to travel to India with toddlers. While weā€™ve loved it, we tend to suggest to people they wait until their kids are a little bigger to go over there. Eric had another great hospital experience in Mumbai, said it was more modern than American hospitals heā€™s visited. But again, Iā€™m sure it varies from hospital to hospital, and no one likes getting sick.

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