Preparing for the Worst

When it comes to natural disasters and other potential crises, diabetes makes me feel frighteningly vulnerable. I mentioned before that the images of Katrina had me clacking my teeth, as I wondered how I might stay alive sans fresh insulin in the event of being stranded. “Really quite my nightmare…”

Well, that hasn’t changed a bit. And now this recent disturbing report from CNN could put any diabetic over the edge to paranoia: “an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn’t be treated.” The list includes, quite prominently, “those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.”

Kassie was one of the first to point this out to the OC. And Michelle K over at Blogabetes was one of the first to ask, “Who’s to say what exactly consitutes ‘poorly controlled’?” Is it enough, in the event of an emergency, for the doctor to know that you have diabetes in order to deem you un-save-worthy? Or is it only those with an A1c over 7? (Who’s admitting to that in the midst of a flood or hurricane?) Or anyone already experiencing any kind of complications? What if you’re sick as a consequence of the disaster at hand, and your sugars are out of control? Does that render you not worthy?

The bottom line is, we don’t want to wait to find out. My husband and I have this frontier-mentality (do-it-yourself-or-don’t-do-it) friend who lives nearby, whose been bugging us for the longest time about getting our home disaster-ready. In our neck of the woods, that mainly means Earthquake preparedness. But no matter. A disaster is a disaster.

So now our backyard shed is full up with canned turkey, bottled water, camping tools and paper towels. And most importantly, in the outdoor fridge: my Diabetes Survival Kit, which my husband and Frontier Guy absolutely insisted on. Yes, I know, the fridge will be of no use in the event of an emergency; it’s just keeping my insulin cool until then.

Diabetes_emergency_kit

The contents of this pack so far are as follows:

2 vials of Lantus insulin

1 pack of 4 NovoLog pen cartridges

1 Novo Nordisk Junior insulin pen device

1 pack of 10 sterile syringes

1 baggie full of about 45 pen needles

1 OneTouch Ultra 2 meter with lancing device & quick start guide

3 vials of 25 test strips each (see, now that IS a problem – there should be MORE in each vial)

3 packs of 10 Glucose Tablets (grape, raspberry and orange)

Enough to keep me alive for about two months I guess — without being able to test too often, and depending on how warm the weather gets, of course. Better than nothing, but I’m still feeling vulnerable.

Anybody have any solid D-disaster-prep advice they’d like to share?

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28 Responses

  1. Elissa
    Elissa May 15, 2008 at 6:50 am | | Reply

    Could you not combine 2 of the vials of strips?

  2. AmyT of www.diabetesmine.com
    AmyT of www.diabetesmine.com May 15, 2008 at 6:53 am | | Reply

    Great idea, but of course they don’t fit together, Elissa.

  3. Gina
    Gina May 15, 2008 at 7:10 am | | Reply

    Amy,

    Thanks for posting this and making my paranoia come back haha jk

    no but really I am glad that you did and I do have my whole closet full of supplies but i dont have an actual emergency kit. Only in the bag that I carry to work every day. The only thing i dont carry is a vial of insulin but i do carry the insulin pen.

    I live in New York, and I always wonder if god forbid we have another attack or I am stuck in the subway if some earthquake or some other natural disaster occurs, will I have enough in my bag to survive, probably not. Maybe I will get a bigger bag.

    I guess we can only be as prepared as we possibly can and hope for the best.

  4. essie
    essie May 15, 2008 at 7:46 am | | Reply

    On the subject of hoping it doesn’t get too hot, when I was traveling in W and Central Africa a few years ago as a type 1 (this was before I was pumping), insulin-safe coldpacks were REALLY good to have when weather got too warm or if I was concerned about not being able to refrigerate insulin. The ones frio (?) makes are really good and fit pens perfectly. you need to be able to submerge them in water I think, but that’s it -

    http://www.frious.com/

  5. Jillian
    Jillian May 15, 2008 at 8:05 am | | Reply

    Already done.
    We even have diabetes survival boxes that include all the non temperature sensitive d-bits and snacks in all of our cars. You know in case we are ever stranded in the snow for days on end etc.
    I also always have an extra meter, vial of insulin, syringes, a Levemir pen, a NovoLog pen, pen needles, extra infusion sets, you name it, in my purse. Surprisingly it doesn’t take up much space, I can fit it all into a small makeup bag which makes transferring it from purse to purse very easy. I’m just as paranoid.

    Let’s just hope that we never actually have to see the day where we might be on the “don’t treat” list.

  6. Matt M.
    Matt M. May 15, 2008 at 8:05 am | | Reply

    “Could you not combine 2 of the vials of strips?”

    “Great idea, but of course they don’t fit together, Elissa.”

    I think what Elissa may mean is to take the strips out of one vial and add them to the other. This is what I do – when I’m running low on strips, I reach for two new vials at once and combine the strips in one vial. You’re right – 25 is too few. I can go through that in a couple of days, sometimes!

  7. mollyjade
    mollyjade May 15, 2008 at 8:20 am | | Reply

    I know this isn’t always an option, but step one of my emergency plan is “get out of town.” Flooding and hurricanes are my most likely disasters, and you have pretty good warning for both of those.

    I don’t keep my extra D supplies with the rest of my disaster equipment. For those of you who have a specific diabetes emergency kit, how often do you switch out supplies? And how do you remember to do it? I have to throw out and replace my emergency food every year because I forget to eat it before it goes bad. And insulin and test strips are a lot more expensive than my cans of beans.

  8. Karin
    Karin May 15, 2008 at 9:26 am | | Reply

    I don’t have an emergency kit but I will tonight. As a side note to this…can insulin be used after it’s expiration date and if so how long? I mean if it comes down to using ‘old’ insulin or not being treated at all…what would you do?

  9. mollyjade
    mollyjade May 15, 2008 at 9:49 am | | Reply

    Karin, as insulin gets older it become inactive. So it works less effectively or not at all. I don’t think you can hurt yourself using old insulin (versus not using any at all), but I wouldn’t count on old insulin if you have any other option.

  10. Bridgid
    Bridgid May 15, 2008 at 10:21 am | | Reply

    I am so glad you put this out there. Our son is 5, diagnosed with D at 20 mos. I was finding it difficult to ensure his health beyond 3 months in an emergency. I have inquired about extra insulin,etc in case of disaster and been met with the “you’re a little crazy and paranoid, aren’t you?” look. At the last conference, a doctor mentioned that the insulin used in the inhaled insulin experiments had been crystallized. Does anyone out there know if there would be a way to follow up on that? Crystallized insulin, if put through quality control for concentrations, could be sold dry in a vial and rehydrated at the consumer level. Theoretically it should be stable for a years under the right conditions. Anyone?

  11. Snowflake Seven
    Snowflake Seven May 15, 2008 at 10:38 am | | Reply

    We should all probably consider having a “Go Bag”, with more than just our D-stuff in it.

    You can Google “Go Bag” for suggestions and you’ll find a ton of advice, but I would recommend starting with Speedbird’s advice on avoiding Go Bag silliness ( http://tinyurl.com/3klduh ).

    In the end you should be realistic about how disciplined you are willing to be about preparedness. It’s easy, really easy, to feel silly preparing and be lazy about staying current. If you cannot imagine a situation happening then your motivation to prepare will fade. Its just like keeping your motivation to have better D control — its work.

  12. Candice S
    Candice S May 15, 2008 at 11:16 am | | Reply

    Thank you so much for posting this. I came across the report you are refering to as a blip on the internet one night. I immediately posted this on 2 diabetic forums and on myspace. Again, thank you for getting the word out about this. We all need to be informed and prepaired.

  13. Michelle
    Michelle May 15, 2008 at 12:05 pm | | Reply

    We talked about this on CWD and we found that many of us hoard insulin. I have some at my home, some at a relatives and some at another location. The hope is that if a disaster were to get to me I’d still be able to get to the extra insulin for my son and the supplies. We have novolog to last roughly 9 months or so. Probably more if we don’t discard after 30 days.

    i remember watching a news coverage of katrina and there was talk about a PWD needing insulin – someone brought insulin to them and it was the wrong kind. I remember thinking “there’s more than one kind?” Ignorance really was bliss.

  14. Sammy
    Sammy May 15, 2008 at 12:38 pm | | Reply

    I think that batteries are missing from your list (for the glucometer). That would suck to be all prepared, and your glucometer is dead or dies from sitting in a shed unused.

    Also something to clean your skin, before you poke your finger. And sugar! What if you go low?

    Why not include extra pump supplies? My feeling is in an emergency (we live in SoCal) I would prefer to rely on the pump as much as possible before falling back on the pen and syringes.

    So that would add maybe five set changes to the kit, 2 bottles of rapid insulin, extra batteries and skin wipes.

  15. Runehawk
    Runehawk May 15, 2008 at 1:31 pm | | Reply

    Anyone with advice as to how to approach the subject of Emergency Insulin with a doctor? I mean, I can gather everything else on my own, but teststrips and insulin need scrips; and how do you handle your emergency supplies’ age? Rescript once every three months or so? -r

  16. Rosalind Joffe
    Rosalind Joffe May 15, 2008 at 1:59 pm | | Reply

    YES! Just my fears and it’s so great to hear I’m not alone. I have two months of ileostomy supplies on hand. I can’t buy my Avonex in advance (insurance!) but I figure I can live without that. I can’t “live” with the ileostomy stuff. I wonder…should I include some extra cymbalta – for nerve pain AND mood in case of catastrophe???

  17. Bernard Farrell
    Bernard Farrell May 15, 2008 at 3:52 pm | | Reply

    You might like to look at the Ready.gov site that has information on preparing your family for disaster situations. More at:
    http://www.ready.gov/america/index.html

    I like the emergency plan document that’s there. We’ll be working on completing this during June.

  18. Linda B.
    Linda B. May 15, 2008 at 8:29 pm | | Reply

    mainly where I am I deal with Hurricanes. I thought extra pump supplies would be good. But, unless you are living in a cool enviroment, where hurricanes don’t tend to go, the adhesives were melting and losing there stickiness due to sweating all the time from the heat. 90= degree weather and body sweat will make your infusion sight fall right out of you. I was also using the pads that gave you extra sticking power. It made no difference, they kept falling out. I now only keep syringes and vials in my hurricane kit, along with my other basic diabetes survival supplies.because of the advanced warnings we now have for hurricanes my biggest survival tip is evacuation .for 10 days I had no power, limited ice and not the right types of foods. If leaving the area will keep me off this “I’m defective ” list they have come up with, believe me I will be out of here. It was adifficult enough struggle trying to find ice and gas,without insulin, I would die before the thirst or hunger ever got to me. I am way more important than my stuff.So I will head north to find my meds.One good thing I found out, depending on the disaster situation, I kept my insulin in sealed baggies floating in my bathtub. The porcelain helped keep the water cool and the baggies sealed out the water. Just an idea for you all.

  19. Linda B.
    Linda B. May 15, 2008 at 8:42 pm | | Reply

    One more thing, I just buy a 110 pack of strips with cash and keep it in my kit, they have a pretty good shelf life. When it gets close to expiring then I go ahead and use it. I have found that the least expensive way to do this has been to get the CVS brand meter. 100 test strips only costs about $52 where I live. Yes the wait time is 10 sec. instead of five, but I am saving 50-60 dollars over other brands.I also ask for samples before I know a storm may be headed our way. My endo is great about helping me out with this so that way I get around the whole insurance nightmare. Just somethings worth looking into.Oh yeah, and those big 50 count bottles of glucose tablets are a wonder. I also keep one on hand everday and when I need to fill my purse container I just fill it. They also have those little, liqid shots I call them. There precisely 15 grams of carbs in each serving, you just open it and drink, I keep several of those handy all around the house.At theend of the hurricane season, I always empty my kit out and use what is left and about a week before the season starts again I fill it back up with new stuff.

  20. geekgirl
    geekgirl May 16, 2008 at 12:10 am | | Reply

    My insurance plan does not allow me to purchase extra insulin to keep on hand for emergency preparedness. (I asked when I was out of town for a long weekend with a full pump reservoir but forgot my bottle of Novolog. No remedy for vacations or emergencies.)

    They cut back on my insulin recently, too, since I use more than 1 vial per month but less than two.. I have a new script from my doctor but we’ll see. It makes me sad to feel as though we have to horde these supplies sneakily. I think I’d better just keep syringes, test strips, a meter, batteries, and some R and NPH insulin in my emergency kit (plus the water and first aid kit). I’ll kick it old school.

  21. Don
    Don May 16, 2008 at 7:10 am | | Reply

    Someone else mentioned Frio’s insulin-safe coldpacks, saying they’re really good. I’d say they’re unbelievably good; I don’t understand why they’re not better known. And yes, all you need to do to get them going is submerge them in cold water for a little while.

  22. AJ
    AJ May 27, 2008 at 2:38 pm | | Reply

    I’m lucky enough to live in a region where natural disasters are few and very very far between. I’m more concerned about getting stranded on the interstate or in a plane wreck.

    When I started watching Lost, and the plane crashed on the island, my first thought was “well, I’d be dead. Damn”

  23. WC
    WC May 27, 2008 at 2:39 pm | | Reply

    You ladies have it easy with your purses. I refuse to carry a fanny pack dammit!

    So instead, I get to have a panic attack every time I step into an elevator.

  24. AmyT
    AmyT May 27, 2008 at 2:40 pm | | Reply

    Mmmm… batteries!

  25. Dina
    Dina May 27, 2008 at 2:41 pm | | Reply

    Here’s the U.S. site for FRIO wallets:

    http://www.coolerconcept.com/

    I’ve had one for several years and it makes keeping insulin cool EASY. My parents live in Puerto Rico so I have LOTS of experience with insulin in the heat.

    All you have to do is submerge the wallet in water for a few minutes. It will stay cool for a few days – until the all the water absorbed has evaporated. Then just soak it again for a bit and voila!

    Easy peasy lemon squeezy!

  26. whimsy2
    whimsy2 May 27, 2008 at 2:43 pm | | Reply

    I guess I’m kind of fatalistic. After Katrina I started saving 2-gallon water filled bottles (the big ones that iced tea from Trader Joe’s comes from). I stashed away probably 20 of them before in the basement — the only available space I have – before I realized that in an earthquake I probably wouldn’t be able to get to my basement anyway.

    I sort of feel the same way about my diabetic supplies. Anyplace I put it, it’s probably not going to be accessible. So why worry.

  27. Stuboy
    Stuboy May 27, 2008 at 2:49 pm | | Reply

    Dont forget a battery for your meter!!

  28. Diabetes Mine - the all things diabetes blog » Blog Archive » New Diabetes Emergency Supplies: Discounted Here!

    [...] that could really help our community.  You may remember that a while back I was patching together my own little diabetes emergency kit, after some reflection on my chances for survival with Type 1 diabetes during a hurricane, tornado, [...]

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