Fall break has already come and gone, and we were headed for Morocco for eight days! As with any trip with T1D, enormous amounts of time and thought goes into packing, so that we can rest assured that we won’t ﬁnd ourselves without anything we might possibly need, that there is no chance of us running out of any supplies, snacks, etc etc! Going to a country that is borderline third world and where I’ve never been made the packing even more intense and important. For the ﬁrst time, I was actually a little nervous when it was time to get the Uber to the airport! Did I remember everything??
Our cooler stocked with enough insulin to last literally months, and a bag full of snacks which could keep the entire family alive for days, we boarded the 3 hour ﬂight to Marrakech and landed in balmy 80 degree weather (another reason for the cooler— it was only going to get hotter during the week!)
After checking into our hotel, we headed out to explore the souks. Walking through the throngs, we bought a snack of grilled beans (couldn’t tell what kind; they were big like Lima or fava beans but black and salty… and delicious!). That was the beginning of ﬁghting what seemed like one week-long high blood sugar! That evening, Carson tested in the high 200s (for some unknown reason we didn’t bolus for the beans). He was rather upset at this as he had just had his second endocrinologist appointment with an A1C of 6.1, about which he was jubilant and proud, and determined to lower it even further. “Don’t worry about one high,” I reassured him, and we adjusted for it accordingly. At dinner, the meal was a delicious chicken tagine, tender chicken and vegetables over couscous, but what we didn’t count on was the large bowl of bread that came with it. I’m talking a lot of bread, dense and heavy. And if there is bread in front of Carson, he’s eating it. Okay, we can bolus for that… but the carbs just kept coming! The drink of choice in all of Morocco is a delicious mint tea, which is pretty sweet so I can only guess the sugars in it. Cookies were being oﬀered at every turn, and large amounts of that delicious, dense bread served at every single meal. I quickly discovered that the dense bread was terriﬁc for a 2 am high that you could set your clock by.
Our other disadvantage was the lack of exertion. Though we were always on the go, none of our activities were very physically demanding. At home in Amsterdam, Carson does something that gets his heart rate up nearly every day, whether it’s boxing, skateboarding, practicing ﬂips at the trampoline park for hours, or riding his bike all over the city. Here, the extent of our physical activity took place on the back of a camel, boarding down sand dunes, or ATV’ing through the mountains. All a ton of fun, but not enough to get him sweating or to keep his numbers in check. Every night, he would go to bed in the happy low hundred zone, but when I would check at 2 am, without fail, he’d be in the mid-to-high 200s, requiring insulin (which sometimes wouldn’t even touch the bread-induced latent high) then another check… you all know how it goes! We had many a sleep-deprived night, but hey, it’s vacation! I wasn’t going to deny the kid Moroccan bread or any of the sweets oﬀered in the authentic Berber homes we were fortunate enough to visit. The 2 am check (and sometimes midnight, and 4 am etc) just became a standard part of the trip.
We did have a worrisome moment when, somewhere between the Agafay desert and Agadir, one Novolog pen went missing and another sprung a leak. Terriﬁed that anything would happen to the remaining one, we looked up the nearest pharmacy and crossed our ﬁngers. What a pleasant surprise! They had Novorapid (Novolog overseas) readily available; we were in and out in less than ﬁve minutes. Not only that, they didn’t need a prescription, and it was substantially less expensive than I was expecting. In fact, this is something I’ve found in Holland as well. Insulin is a fraction of the cost that it is at home in the States. Makes one wonder… but that could be the topic of an entire diﬀerent post.
Hugely relieved to have a fresh box of Novorapid pens, we enjoyed the rest of our holiday without incident. After our stint in a tent in the desert, the last couple of days were spent at a resort with a small gym, so I decided to put the theory of physical exertion to the test. Carson ate just the same; sweet mint tea, heavy, carb-laden bread and couscous at every dinner, and baked goods throughout the day and for desert. But here, he and I worked out together in the gym before bed. Eureka! The 2 am checks were suddenly back to normal. This was something I knew was true in theory but had never really put it to the test. Now there was no doubt that exercise truly does help keep those sugars in line!
Now back home and with school back in, it’s even more important to me that Carson do something not just mildly active, but strenuous each day. There have been no complaints from him as his favorite activities are the ones that get him sweating! We’ve been home for two weeks now with nary a high blood sugar on record.
Post Script: this past summer, we made the decision to go oﬀ the CGM. Having had major adhesion trouble (huge shoutout to Dexcom, for being so patient with us, and warrantying almost every sensor that we put on and then came oﬀ my son’s oily, sweaty skin within days), we decided to go back to ﬁnger pricks, just for the summer, when it was easy to test more often. After two months of this, Carson’s A1C was 6.4 and our endocrinologist said if it’s not broke, why ﬁx it?
Once we got to the Netherlands and school started, his classroom was so ﬂexible about letting him test anytime, we chose not to go back to the CGM yet and see how it went. As mentioned before, his A1C dropped from a 6.4 to 6.2 and then, most recently, 6.1, so we continue to ﬁnger prick for as long as it’s working for us.
Dove Braunstein is Carson’s mom and Team Captain of Team El Niño, winner of the JDRF 2017 Top Gun Trophy as #1 San Diego Walk Team with over $62,000 raised for T1D Research. Dove, her husband Blake and their son Carson have left the friendly confines of San Diego to live for a year in Europe and she will be sharing their adventures and challenges of managing T1D in their new home country of Holland.