Amy’s T1D Adventure: Cooped up in Cuba

Sunrise in San Pedro

[Here’s a guest post series from Amy McKinnon, a One Drop user and 27-year-old ex-advertising executive who recently swapped her NYC apartment for an oversized backpack to explore the streets of Latin America for six months. Amy has lived with type 1 diabetes for 15 years and tries her best to balance blood glucose levels, marathon training and a high-carb raw-vegan diet. Now she has thrown travel into the mix. EDITOR’S NOTE: Amy is a performance athlete and consumes a high carb diet. At One Drop, we believe that a low carb approach to food reduces the risk of hypo and hyper glycemic incidents and can effectively reduce blood sugars. However, we want to share a variety of personal experiences so we can all learn how other people live their lives with diabetes. Always consult your doctor before making changes to a prescribed regimen.]

A Water Fast in San Pedro

One Drop Blood Glucose LogSan Pedro sent me off with a very warm goodbye at 6am with a magical sunrise. It was going to be a long couple of days traveling to Cuba, so this was the perfect start.

I had decided to try a water fast for the first time that day. My friend and fellow T1D health and nutrition specialist, Cyrus Khambatta, had recommended this to me in a recent call I’d had with him. He is the infamous gentleman who started me on the low-fat, high-carb regime, so I had many reasons to follow his well-researched piece of advice.

So my day involved lots of water, an 8am ferry from San Pedro to Chetumal, Mexico, a long 5-hour bus ride from Chetumal to Cancun and then a taxi to the Comfort Inn at Cancun Airport – my overnight stay.

A couple of times throughout the day I thought I was going to give in to my hunger but I persisted with slightly elevated blood glucose levels, but stable with intermittent very small doses of insulin. By the time I got to the hotel I was so exhausted, quickly skyped my parents and crashed out.

Blood Glucose on the Run

I woke up in the morning with an odd feeling. I had stomach cramps and a headache. Thinking it might be hunger, I tested my blood glucose and it was 180. I gave a correction dose and didn’t think too much of it, until I noticed that my pump infusion set connection had come lose during the night and it was now evident that my insulin was not being delivered and the ill feelings I had were most likely ketones.

This had happened to me once before and the way my body felt was exactly the same.

I gave an ample amount of insulin for breakfast on top of my correction dose, waited half an hour and went down to breakfast, filling up on fresh papaya, watermelon and cantaloupe. 1-hour post breakfast and my blood glucose was 360! Arggggghhh! Not how I wanted to start my day.

Normally I would have checked ketones and waited for them to disappear before I had something to eat, but with a deadline to be at the airport, I went against my instinct knowing that the likely result would be a high blood glucose. But with insulin now in my body the headache and stomach cramps disappeared.

I stretched in my hotel room, checked out, gave additional insulin, put on an increased temp basal and headed to Cancun airport.

With a few hours before boarding, I wandered the halls of the airport trying my best to bring my blood glucose down — when my blood glucose is elevated, mixing insulin with low-impact cardio like walking generally brings it down within an hour or two.

Not today. Today it took 3-hours to get back in range. But thankfully, just as I was landing in Havana, Cuba, I was at a lovely 85. Patience and persistence sometimes is the only answer.

I grabbed my bags, met my pre-arranged driver at the airport, exchanged my only cash — less than $100 USD — for CUCs (Cuban tourist currency). We set off for the Casa in Old Havana, where I would be staying for my time there. My first impressions of the surrounding area: a lot of run down old colorful buildings lining the streets and lots of people around.

Cash is King

Cuba has two currencies—one for tourists and one for locals. If locals get their hands on the tourist currency they have the rare chaHotel Nacionalnce to purchase luxuries they are otherwise not exposed to. With the rules around rations and very limited stocks within the supermarkets, Cubans don’t even have access to liquid soap.

After settling in at the Casa, my first destination was the bank. With absolutely no cell reception, I immediately got lost after not quite following the instructions of my hosts. Everyone I asked was extremely friendly and helpful leading me to the National Bank of Cuba. I waited in a very unstructured line with the locals outside the bank waiting to be let inside to another queue.

After waitin in line for an hour, I learned that they don’t take MasterCard at this bank. Deep breaths, some dried fruit to keep my blood glucose in range and a walk to another bank…. I line up again, knowing that they do take MasterCard here.

Finally, I’m up. The ATM spits out a note: ”No aceptar” — my card is not accepted. What?! Oh shit. I realize Cuba (or should I say, the United States) does not allow you to use their cards in Cuba. A few French words ran through my head as I remembered I had two back up Australian cards I could try tomorrow morning.

It was almost 7pm, so I headed back to the Casa for dinner with fellow travelers — dinner was an array of vegetables, beans, rice, bread and fruit. I ate as much as I could, not having properly eaten since 830am. Down to only $40 cash, I signed up for breakfast at the Casa the next morning, knowing I could pay for these meals upon departure.

My host contacted the Canadian Embassy for me before I retired for the night and they gave me details of a Cuban agency who may be able to help me with a cash advance while I sorted out the issue with my cards. I could also go to the Canadian Embassy (there isn’t an Australian embassy in Cuba) on Monday as well for assistance, but that left me with some uneasy feelings … I really hoped my Australian cards would work the following morning.

New Day, No Luck

Saturday morning I rose early with a blood glucose of 90, headed to the bank, hopeful and slightly desperate. “No aceptar” appeared for both my Australian cards – supposedly they were associated with US banks…..really????!

Next stop was Asistur – the Cuban agency that helped travelers in my situation. Even though they were closed I briefly spoke to a man who advised me I needed to contact my bank and insurance company to give them official notice I couldn’t access my money.

Waves crashing against a wall in HavanaI snuck breakfast in so I had a full tummy before making these calls — 1 banana, 1 slice of pineapple, 3 chunks of papaya, a pancake and lots and lots of sweet bread. I knew I wouldn’t be eating again until dinner time. The bread shot my blood glucose up unlike anything else — maybe the stress added to it as well. I was back up to 360 and not happy.

The Canadian Embassy emergency line was great in connecting me with all the companies I needed to speak to in Australia, which gave me some reassurance I could contract people even without Internet. By noon I headed to one of the ritzy hotels here, paid $4.50 of my limited funds to gain wifi access and email my parents an update on my situations. I also planned on calling them when they would be awake – around 4pm my time.
Emotional, stressed, high blood glucose, and no money, I tried to take my mind off the
situation with a walk around Old Havana. After a couple of hours, not really paying attention to my surroundings and feeling dull, I headed back to my room and tried to read my book between many many tears of frustration. I felt totally trapped. I couldn’t do anything that might create an expense. I was stuck in Havana, not able to leave and not able to enjoy the city. I didn’t know how long it was going to be until I could access money. I was limited by my food choices, I couldn’t exercise because I didn’t want to use my low blood glucose supplies unnecessarily and I felt unwell.

A few hours later, I went downstairs and called the Canadian Embassy and was connected with my family. Hearing my Dad’s voice as he answered the phone, I burst into tears again. Crying is so emotionally exhausting. He reassured me everything was going to be okay and I was going to be able to access money in the next couple of days. He had a plan and told me to expect an email tomorrow evening, after he spoke with the Canadian Embassy in Australia.

A castle beside the oceanAfterwards I felt a little better and so grateful for my family who would drop everything to help me. I headed outside in the rain for a walk to get some fresh air into my lungs. I walked down to the Malecon – a wall that separates the ocean from Havana. It was a stormy day and the waves were crashing hard over the walls, the road having to be blocked as it was too dangerous for cars to drive alongside the water.

Getting off the High Train

One Drop blood glucose logBy dinner time I felt better, more positive and a bit of comfort after speaking with my family and getting their reassurance that I would be okay. My blood glucose was down to 90 after my walk and that probably helped release some of my sullen mood too.

High blood glucose levels never make me feel good, physically or emotionally, that is one of the motivators that helps me try my best to keep my blood glucose in a tight range. Being high all day, combined with a large amount of processed carbohydrates and emotional stress, was hard on my body — something needed to change.

Before dinner, I made the decision to swap from my pump back to injections. I knew I’d be eating refined carbohydrates for the next couple of days while I had no access to money, and my insulin doses would be almost double than usual to compensate.

I gave myself 16 units of Lantus and a massive 10 units of Novolog to cover my dinner — a similar combination of beans, rice, vegetables and bread from the night before.

The rest of my evening involved taking it very easy, watching a Cuban concert on the fuzzy TV in my room and reading my latest book: Ballerina, Misty Copeland’s autobiography.

Sunday morning, I rose with a new attitude — positive, relaxed and ready to stop feeling sorry for myself. A blood glucose of 180, some morning sit-ups and squats, and a 10-unit dose of Novolog — I filled my stomach with the same breakfast as yesterday and headed out for a long walk along the Malecon.

My destination was Hotel Nacional. The view along the harbor with colorful buildings, facing the ocean and the cloudy sky was magical in its own unique way. The hotel was beautiful, with beautiful views of the ocean and a stunning interior. The hotel is infamous for hosting guests such as Frank Sinatra, Marlon Brandon and John Wayne (just to name a few).

A quick blood glucose check before I walked back along the Malecon to my next destination—250. Not as bad as yesterday — I gave an additional 2 units to bring it down.

Forbidden Fruit

Funky Art in HavanaI felt a little trapped by my restricted food choices, especially when walking past the street fruit stalls filled with papaya, pineapple, bananas and oranges. I wanted them to be in my tummy so badly, instead of the bread which was already giving me that bloated and inflamed feeling, taking me back to the days when every day I thought it was normal to feel like crap. Now I knew that it wasn’t.

The walking was making me feel better so I continued on, arriving at Plaza San Francisco – known for its funky art scene.

It was raining on and off, but I knew I had to keep myself occupied and the walking was good for my blood glucose levels. I enjoyed wandering the streets, seeing a snippet of the Cuban way of life — simple, limited, but still warm and friendly…particularly the men who did not hesitate to tell you how they felt about you, one after another. It made me laugh and I’d smile and say “gracias” on most occasions.

Kids playing barefoot soccer

I stumbled upon Plaza Vieja, a nice scene of local children playing a game of barefoot soccer with a backdrop of pristine tourist-marketed restaurants and hotels. I enjoyed seeing this contrast and clash between two very different worlds.

Walking Toward a New Tomorrow

Cuban men seem to have this innate confidence. A few young ones fired up a conversation with me….and funnily enough one of the things that caught their attention apart from my “Cuban figure” was my type 1 diabetes tattoo. They knew the symbol meant medical and they humored over it as they enjoyed engaging in a Spanglish conversation as much as I did. I kept the conversation short as I wanted to keep walking – getting lost in the streets of Havana was fun and totally safe, even after dark. As I made my way back to the Casa, I took some photos that I felt represent Havana to me. Dirty, run down, but exuding a unique warmth.

Old car parked on the roadArt wall in HavanaRun down restaurant in Havana

This walk made my feelings towards Cuba change from my first rough couple of days. I saw the warm, friendly place everyone had told me it was. I was grateful for today. Before the rain got too heavy, I walked passed the famous Capitolio — under construction like many other buildings in Cuba, but still an architectural masterpiece.

Tomorrow is a new start to the week and I know deep down there are going to be positive results.

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Amy McKinnon
Amy McKinnon

Amy McKinnon is a One Drop user, marathoner, ex-advertising executive, and has lived with type 1 diabetes for 15 years. Amy is currently exploring the streets of Latin America for six months.