Dude, Where's My Meter Case?

We went to the Dominican Republic recently.

This was a work-related trip for Suzi, and it was pretty much an all-expense and inclusive trip for roughly four days to the resort community of Punta Cana. I'm so very lucky because I was able to just go along for the ride. I've never had a passport, and so this was my chance to snag one and use it (grew up in Detroit, and have visited Canada and Mexico in the pre-9/11 days, but never needed a passport since I'd never entered international waters like this).

I did all the diabetes-related packing of supplies and prep, and after weighing all the tropical temp issues that could arise, decided to only take one opened bottle of insulin. I kept the insulin in the mini-fridge, rather than inside my meter case pouch at room temp where it typically lives. All was good for the trip, and my insulin pump worked well along with a few scattered MDI instances when I didn't want to be connected by the pool or ocean.

I didn't need to do many finger-pokes, since I was wearing my Dexcom and that was working well
enough for me.

Our final full day before leaving, I ended up with a Dominican-style stomach bug that knocked me on my behind. So, I spent a good amount of time in the room and then, the day of our departure, was about ready to head back to the winter weather of Indiana.

In packing and not feeling well, I grabbed all my diabetes related supplies. It was nearly time to refill my reservoir, but because of the intense tropical heat and my illness, I opted to not refill my pump but instead to inject insulin as needed. That way, if I was stuck outside in the heat, my insulin in the pump wouldn't get too hot and degrade -- leaving me with the "insulin is like water" effect and higher BGs.

I also wasn't wearing my CGM at the time, as it had come off in the tropical heat the day before -- and because of the sickness, it wasn't giving me accurate data anyhow. This just meant I'd have to be more diligent in my fingerstick checks, especially with the illness spiking my BGs even more.

With those important D-decision made, I pulled my insulin out of the fridge to put it back into my black meter case, which would then go into my front zipper pouch of my backpack.

And off to the airport we went for a full day of travel back to the States.

The Panic Sets In...

Hours later, sitting in the Dominican airport waiting for our 2-hour delayed flight and still not feeling well at all, I decided to just do a blood test, since we only had about 30 minutes before the flight at that point.

That's when the panic began.

In digging through my backpack, I could not find my meter case. It was missing. More frantic searching resulted in nothing.

At that time, I realized a few things:

- my black D-case was gone along with everything inside it -- my meter, doctor's note and and backup insulin Rx.
- My bottle of insulin (gulp)

Since I wasn't wearing my pump and had high BGs already due to my sickness and MDI mini-boluses instead of basal stream, this was not good. My last injection: 4 hours ago, with my BGs hovering in the 200s.

Well, fuck.

At home, I have more than enough meters as back-ups. But that wasn't my concern. I was not worried about the strips or anything else in there... my only bottle of insulin I'd brought for this trip was what I really needed. And the written Rx for backup insulin.

Double, fuck.

A brief airport tiff about my losing or leaving behind the meter case ensued, and it didn't really matter where or what happened because it was just gone. And we didn't have much time before the flight left.

I paid the extraordinarily high phone cost of calling my doctor's office back in Indiana to get an emergency Rx called in. Didn't know a specific pharmacy, but since we didn't have Internet access in the Punta Cana airport, the doc's office searched and found a Walgreens up near Chicago where we planned to stay the night.

All seemed OK.

But it wasn't, as it turned out after we returned to the States and landed in the Chicago airport.

Finding Insulin

Six hours after leaving the DR and with my BGs creeping higher, we landed in Chicago. I phoned the local pharmacy ASAP once we were through security and awaiting the bus to drive our group back to NW Indiana.

It was just before 9p, and that's when I discovered that apparently, the Walgreens pharmacy wasn't 24 hours as thought. And no, they weren't able or willing to transfer the Rx to the 24-hour Walgreens right down the fucking road, instead telling me I would have to have it called in the next morning.

My BGs were at 400 mg/dL, and my last insulin injection was 8+ hours ago.

FUCK!

We had planned to stay the night in northwest Indiana and had already booked a room, especially because a forecasted snowstorm was already beginning with heavy flakes falling from the sky.

But realizing how dire my no insulin situation was, we changed plans.

There was no way I could get through the night without insulin, and I feared going into DKA if another option didn't present itself. While I could have gone to a CVS or Walgreens to snag a bottle of older insulin for only $35, I was frustrated because I had tried to fill an Rx for the Humalog that I really needed.

I contemplated an emergency call for help from the DOC on Facebook or Twitter, but realized that would probably spark more fear and panic than it was worth.

At this point, I was so very tired and just totally down on myself. I felt like shit, blamed myself for what had happened, and was scared out of my mind that getting insulin wasn't going to happen short of going to the nearest ER.

Yes, I took my frustration out on the second Walgreens pharmacist Pete who didn't appear to be able to help me, and insisted he give me his name so I could tell that to the ER doctors when I likely ended up there, on the brink of death.

A little unfair, but that's where my mind was at. He also didn't tell me about the other insulins that were probably sold there for cheap, and at the time I wasn't thinking clearly enough to recognize that as an option.

We decided to not stay the night, but instead drive the three hours home to Indy. Despite the now-falling snowstorm and crappy slush-covered roads, most of which would be dark since we have to drive through the nothingness of Central Indiana where they don't believe in highway lights.

After the hour drive back to the hotel where our car had been sitting for four days, we managed to transfer our room to someone else who was trying to find shelter from the winter storm.

We got back on the road and headed home. It was approaching midnight.

That's when my wife mentioned something I hadn't contemplated earlier, in my insulin-starved and still-sick mind:

Phone the on-call doc at my endo's office.

That worked, and we had her fill one at a confirmed 24-hour Walgreens in the next-nearest location on the path we were on heading toward Indy.

We stopped halfway between Chicago and Indy, and after two attempts, found a hotel that wasn't booked. And we picked up the insulin, paying $150+ for the single vial while also politely listening to the nighttime pharmacist pitch one insulin brand over another that might be "cheaper."

Yes, I realized then that the $35 old insulins could also save me, and I felt a little guilty for being so dramatic when that was an option. Still, I now had the Humalog and that was reassuring -- even though I knew it would take a few hours for that to start bringing my blood sugars down.

Since I had packed my backup syringes in my luggage, we had all that we needed now.

About 2am, I finally had insulin in my system and we were ready to crash for the night. The stress, frustration, tiredness, high blood sugar and general stomach bug sickness were all at high levels -- not to mention that I hadn't eaten or drank anything at all in 24 hours.

Finding What Was Lost

The next morning, my blood sugars were fine. The sickness was passing, and I got some gradual food in my system by the time we got home to Indy about noon.

We tried to just laugh off the adventures, forget the stress and relax now that we were home on comfortable territory.

And that's when I dumped out the cotents of my backpack, and saw a black zip-up case fall from the covered up bottom beneath my Neal Patrick Harris autobiography and other random stuff.

Yep, the meter case had been in my bag the whole damn time.

The whole fucking time.

That figures.

Apparently, I really did plan accordingly... I just didn't realize it at the time. I feel like an idiot, needless to say. And can't apologize to my wife for all the unnecessary stress and headache I tacked onto the return-home part of our trip.

But hey, at least I got an adventure and story out of it, right?