I am a 26 (almost 27 yikes) years old first generation immigrant woman living in Canada, where I have been living for 25 years. I have loved Japan for very many years, for various reasons, and although I can’t exactly pinpoint when exactly that this love started, I know that, just like most foreigner, a lot of it started through animes & Japanese animated movies. Hayao Miyazaki & Studio Ghibli’s works, Mamoru Hosoda, the Final Fantasy franchise (FFX being my one true love in life), growing up alongside & through Pokemon, Sailor Moon and Cardcaptor Sakura, and a whole love of Shoujo mangas. Visiting Japan very early on was added to my Bucket List of life, residing and remaining in its #2 spot for all this time, until I met my partner who has had a very similar experience and a very similar love for Japan, together, in January 2018, we finally purchased out tickets to Tokyo, Japan (which will be the focus of our 12 days trip). Now I knew that I wanted to write some travel logs both for my followers on A Woman on the Internet as well as fellow Japan lovers, but I specifically wanted to share my experience travelling as a Type 1 Diabetic (and recently diagnosed at that, 2013) due to the very limited of information and articles about Type 1s specifically who travel, and travel/travelled to Japan.
In this entry, I’d like to focus on a very big part of any trip preparation, almost regardless of where your trip will take place. Sam & I’s trip will be 12 days long, or rather, 11 days and a half. There were a lot of things to take into account and prepare for as soon as we booked our tickets, so I’d like to make a list for any Type 1s out there to make sure that you don’t miss anything. Here goes:
1. 3+ months before leaving: Call & book an appointment with your Endocrinologist.
Considering that appointments with an or any Endocrinologist can take up to 3-6 months wait time, it is imperative that you take in account that you absolutely need to see them before you leave, whether you need to take an appointment before booking a ticket, or as soon as you do, simply make sure that you do. During that appointment, let your Endo know of your trip & where you will be going, make sure that your diabetes is in control, or that you have the time to settle things prior to leaving. Discuss the trip with them, ask if your dosage needs to be adjusted, you may even be asked to see your Nutritionist.
2. 3+ months before leaving: Call & book an appointment with your health professional or family doctor.
Just as number #1, make sure to let you doctor know about your upcoming trip and where you will be going, as well as for how long. Your doctor may recommend you to renew your annual shots, depending on whether you will be travelling during flu season or not, take in account that as a Type 1, which is an autoimmune disease, your immune system does not work like other people and we are more vulnerable to getting sick. Get a blood test done, get a general check up, get any recommended or required shot, make sure everything is ok and that you have the green light from both your health professional as well as you endocrinologist.
3. Get familiar with Japan’s laws & current state in regards to foreigner & diabetics visiting.
It is very important that you understand that, in Japan, a diabetic cannot purchase any diabetes related items or medication without a doctor’s appointment. Unlike, for instance, France, where you can purchase injection needles and such in any and all pharmacies (although, obviously, out of your own pocket), Japan does not work like that, and that running low on medication, for instance, would be very inconvenient at best, and very dangerous at worst. Most doctors & pharmacies also generally have staff that, usually, have limited amount of English (and most likely an even more limited knowledge of other foreign languages). Keep in mind that you will have to travel with more items and medication than usual, plan ahead, and plan for emergencies. Keep yourself updated with any and all law changes.
4. Make sure that your diabetes is in check.
In the weeks prior to your trip, keep an eye on how your blood sugar is doing, make sure, after your appointment with your health professionals, that you take in account and apply any adjustment that you were asked to apply, make sure that your health is in the best state it can, so that you & your body can be in the best or ideal condition before your trip as eating & visiting in a foreign and new country can be both stressful but can also throw out of the window any tight schedule your may be used to.
5. Keep a close eye on your Ketones.
As someone who has been hospitalized in emergency twice for two DKAs in the past year and a half, I have had to take the time to purchase a Ketone reader and keep a close eye on those readings. Prior to my trip, especially in the two weeks before, I made sure to get at least 2 readings a week to make sure that I was ok, whether or not my blood glucose numbers were good (especially if they were not) as it is incredible important to avoid any hospitalization while abroad, especially one as dangerous as a DKA.
6. A week or so before: Ask your pharmacist (or doctor) for the entire list of all of your prescriptions.
Japan, like a lot of countries, strongly recommend (if not require) that you travel with the
complete and up-to-date list of all of your supplies and medications that you will be bringing with you. If you travel with insulin, and insulin pump, needles etc. make sure to ask your pharmacist or doctor to print all of those for you, as you will want all of that information on your person at all time, especially while travelling & while being inside any airport or aircraft.
7. A week or so before: Purchase your supply & medications.
As you plan your trip, make sure to plan as best and accurately as you can the amount of supplies and insulin that you will need while you are abroad. As someone who takes about 30 to 50 units of short term insulin and 16 units of long term insulin per day, I needed to calculate how much I would need exactly for 12 days abroad, while also taking in account extra units I may need or emergencies that may occur. As some people may know if you know me from AWOTI, last year I had trouble returning home to Canada from Morocco as officers somehow could not identify me as a resident (it’s a long and ridiculous story), due to this, I was denied entry and remained stranded in France for 9 days. There, after learning that my luggage had also been lost, I was stranded without extra insulin or needles, and had to purchase extra. My insulin was a different story and I had to cut back in order to make it. Make sure that you plan according and place for emergencies. This brings me to point 8.
8.Consider that you will have to travel towards Japan with your medical supplies on you.
As previously mentioned, you will need to travel with a list of your medication & prescription, but you will also need to travel with the original packages in which your medications came in as well as your insulin, needles etc. the prescription & packages will serve as insurance that you are to be allowed to travel with this. If you feel anxious, ask your health professional to write you a letter so that border agents don’t give you too much trouble. Keep in mind that most people are not informed at all in regards to diabetes, they may give you a hard time, make sure they understand that these are life and death health necessities, travel with them, do not leave them in your luggage where it can be lost or will experience big changes in temperature.
9. Inform your carrier that you are a diabetic.
While you may have done this already after booking and perhaps even selecting a diabetic meals (they are worth selecting, trust me) you may want to take the time to contact your carrier to let them know that you are diabetic and so disabled and that you may need assistance while in flight if you experience a hypoglycemic episode, this is worth emailing them about just in case.
10.Purchase a diabetic bracelet.
So, this is optional but I highly recommend it. Travelling or not, a diabetic bracelet is something that could save your life if something were to happen to you, as you would be identified as a diabetic, which would help paramedics and doctors treat and care for you in emergencies. You can find a diabetic bracelet at most pharmacies, plastic or metal, they are usually cheap.
11.Relax.
I know, this seems like a lot, but as soon as you see your health professionals and get all of your supplies, all that is left is waiting. Flying while diabetic isn’t that big of a deal in and out of itself, as long as you yourself are fine, and especially if you travel with someone or with a group, simply let others know and keep in mind that it is absolutely ok to tell people when you need help or need a minute. As long as you plan extra supplies & plan your insulin accordingly, all that is left to you to do is what we all already so every single day of our lives: eat & do math. But this will be something I will be getting into when I myself get to Japan. I hope this was helpful, please let me know if you have any questions or would like to add anything this list & entry. Are you a Type 1? Have you ever travelled to Japan?