Diabetes Self-Management Blog

Since I was away last week, I have a double entry for you here. Enjoy.

Last week I was in Nicaragua with my wife, visiting some friends who had moved there after Hurricane Katrina. They lived in New Orleans for a while after Katrina, but then decided to pack up and drive to Nicaragua, a place they had visited a fair number of times but never actually resided.

We left NYC for Atlanta at the crack of dawn last Thursday morning, not really knowing what to expect. Should we have taken malaria shots? Would I be able to keep my insulin refrigerated? What are Sandinistas? (The standard three questions.)

I took my morning injection in the Atlanta airport after a breakfast of eggs, grits, and bacon. I felt great and so did my stomach. It was in my standard 8:45–9:45 AM window for the morning injection. I always shoot for 9 AM on the dot, but when traveling I find I’m a little more flexible.

After the three-and-a-half hour flight from Atlanta to Nicaragua, we landed in Managua and made our way to the customs line. I delivered my best Spanish, and I must confess that there are a few words I say that make people think I’m fluent. I’m not, but I can get my point across and understand enough to avoid standing around looking like an imbecile. However, sounding really convincing on the few words you say only leads to asking people to speak slower and repeat everything they say two or three times.

After getting through customs, we made our way outside and found our driver after overhearing him ask another couple if they were Andy and Katherine. We loaded into his car and headed west to Rivas, where our friends Gibson and Carrie were going to meet us. After the hour-and-a-half drive, we met our friends and loaded into their car for another hour-and-twenty-minute drive to their small beach town, which doesn’t really have a name.

They took us to a restaurant in Rivas before we started the drive for some local cuisine. Not many healthy items on the menu, so we all shared a couple of orders of fried plantains and cheese and a beer. I added a granola bar to my lunch as I took a unit of insulin for the plantains and beer. We drove for the next hour on bumpy dirt roads and finally made it to their house on the Pacific Ocean. My stomach was feeling…average.

The waves were enormous and I noticed them before I put my insulin in the fridge—which says something for the size and noise of the waves, as I’m often in a hurry to get insulin into the refrigerator when I’m in a hot place. I always have the fear of leaving it in my bag in 95° heat and ruining the bottle.

After exploring their new home the first day, we went out for dinner at one of the few places to eat out. I had snapper with rice and beans and took a couple of units for the rice and beans. An hour later, my stomach felt below average. I tried to sing my stomach pain away with a few ukulele tunes with my wife and then a game of Ping-Pong. Nothing worked; I was going to have to open the floodgates. Insert your own sound effect here. Not to go to into depth about my stomach problems in Nicaragua, but let’s just say that my theme for the whole trip, which will one day be the title of a comedian’s album, would have been, “Afraid to fart.” I think everyone can relate to those three simple words. Now, back to the story.

We decided to go out for a surfing lesson the next morning at a beach where the waves were not so big and dangerous. We loaded up the big board, ate some wonderful fresh fruit for breakfast, and set out to hit the waves. My stomach felt a bit better, but I was still afraid. I ate half a PowerBar on the way to the beach and, once in the water, I lasted about 20 minutes before I had to return to the car to eat the second half. Surfing was way more of a workout than I had expected. I was thinking it would be a challenge, but had no idea about the amount of paddling and energy I would be expending. I could feel my blood glucose getting low in the water and didn’t want to risk a really bad situation.

After a little energy boost, I managed to sort of stand up on the board in a kind of crouched position that I later learned is what surfers call “pig doggin’.” Sounds pretty awesome to me, and even the best surfers have to do it when they are catching a “sick” or a “gnarly barrel.” While I didn’t learn to surf like a pro in our few days in Nicaragua, I think I did learn to talk like one. We went fishing with one of the local surfers/fishermen, and he taught us the proper lingo to use to sound like we were in the know.

We caught dinner for 15 people on our fishing trip—two nice-sized mackerel, and my wife caught a 30-pound rooster tail fish. They aren’t the best to eat, but the locals enjoy them, and we traded the 30-pound fish for almost two pounds of lobster tails. We had a great dinner of fresh fish and lobster that night. My stomach rejected it four hours later, but that’s another novel.

While out on the boat and in the heat, I was constantly snacking and had a few beers, and I checked my blood glucose frequently. It amazed me how much the sun and being bounced around by the boat lowered my blood glucose. I hovered around 120 mg/dl the whole time we were on the water. I understand that alcohol can lower my blood glucose, but I think it had way more to do with the heat and the constant up and down and contracting of muscles to hold still on the boat. My stomach was better on the water than on the shore.

We had a great trip and made it back to NYC late Monday night. Nicaragua is a very “undiscovered” country in many areas and I wonder if it will still be the same in 10 years. There seemed to be signs of “gringos” everywhere. We saw a Century 21 office during our drive out of the beach town. But then we saw pigs and chickens in the road and oxen pulling rickshaws just a mile ahead. It will be interesting to see what happens.

If you’re into surfing or just exploring remote areas, I recommend a trip to the Pacific coast of Nicaragua. If you have diabetes, be prepared to eat a lot of fish and drink plenty of bottled water and always, I repeat, always be afraid to fart after dinner in Nicaragua.

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Traveling With Diabetes
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