My d-holiday in Thailand

Guest Post, Sally Marchini, Dietitian

Wow! I really needed that break! I had concerns about my diabetes and coeliac disease before I left, but other than a few minor hiccups, they were fine.  I prepared well, and was mindful of my activities (as much as possible) so thought I’d share some of the highlights with you.

You probably all know how I feel about routine being so important for diabetes control. I really didn’t know how I’d go with a complete break from my usual routine.  I was also concerned about the impact of the high-GI foods in Thailand, and from a coeliac perspective, the availability of low-GI gluten free foods. So, I decided to be organised and ensure I took with me what I needed:

• 10 measured packets of my low-GI GF cereal
• 2 loaves of my low-GI GF bread
• A few juice poppers in case of night-time hypos
• Mixed unsalted nuts for snacks

 

And I was glad I did that as it did make a big difference!  Of course I also took a spare BGL meter and loads of extra fast acting and Lantus insulin and Glucagen but fortunately didn’t need them.

The Flights

I also had to think about the plane flights, as we flew with Jetstar  and they don’t provide gluten free meals. For the way over I made a frittata with lots of veggies, sweet potato and cannellini beans (for low-GI carb) which was very tasty, and my Mum (who I was travelling with) was envious as her in-flight meal was not nearly as appealing. I also took a couple of pieces of my low-GI GF bread and a jar of peanut butter, an apple, a box of nuts and a juice popper for the flight. Worked out perfectly, but I didn’t need the popper (no hypos).

 

On the way back we slept most of the way, but I took a baby banana (provided every day in our room as part of a fruit platter) and boiled egg from the resort and had those with bread and peanut butter for my on-board breakfast.  Very satisfying – a peanut butter and banana sandwich with an egg on the side!

 

The Resort Food

We had breakfast included in our package which was an enormous buffet of cereals, breads, pastries, European food and Thai food as well as the usual cooked breakfast options.  I missed my coffee as, although they offered coffee, it was different to the coffee we have here.  Of course, I had brought my own cereal, and I indulged in a freshly made omelette most days – most delicious. I also tried some Thai breakfast options including a clear broth with pork and cabbage with a fish sauce-based chilli seasoning. Very zingy and tasty!

I found that being coeliac wasn’t much of an issue there, but was glad to have my own cereal and bread. For lunch we took a selection from the European breakfast option of cold meats/cheeses and salad to make our own sandwiches in our room.

 

The night time meals were pretty easy to manage other than having a higher glycemic index/load than I’m used to.  Most of the seasonings were based on fish sauce, tamarind, lime juice and coconut milk, so I really only had to watch out for soy sauce. And the noodles – some were wheat based, but they’re pretty easy to spot so I just avoided those, and of course there rice and mung bean/glass noodles always available.

When we ate at the buffets in the Resort, the staff were only too happy to have the chef prepare me special meals to my liking, so I felt very spoilt and had no accidental glutenings.

Food outside the Resort

We had only one day excursion from the hotel (other than local restaurants in the evenings) and although I checked 3 times with the hotel tour operator that there would be gluten free food available on the day, when we were on the bus on the way to lunch the guide asked if anyone had any special food requirements. When I advised I needed gluten free food, he really had no idea. There were ten Australians on our bus and everyone tried to explain on my behalf (how sweet), but when we got there they’d misunderstood ‘wheat’ as ‘sweet’ lol. Suited me too, but the 3 dishes offered, one was sweet & sour pork (too sweet for my taste), one was spring rolls (not gluten free) and the third was a chicken and eggplant green curry. The restaurant made me an extra serving of the green curry very kindly, so all was good including my BGLs as the coconut milk lowered the GI of the high-GI rice they served with it!

We also went to a market one day which was fascinating to see the various vegetables available as well as the meats and even insects.  We didn’t eat anything there as it was very hot and didn’t look clean, but wished we could have tried some of the fruits and vegetables on offer. In the resort the only real green vegetable dish offered was called Morning Glory that was served stir fried.  Vegetables were one of the foods I missed most on this holiday, and I normally eat about 6 serves every day of fresh veggies.

 

The local restaurants were fantastic and I had no issues with any of their meals, other than perhaps eating too much 🙂

 

 

My diabetes control

As mentioned at the top, I had concerns about how my diabetes would cope with a complete change of routine. With the weather being in the high 30s and very high humidity, it was really too hot to exercise. My usual exercise routine helps to keep my BGLs steady across the day, and that was reflected in higher BGLs than I would usually have. I had a few up around 16mmol/l, but these were easily corrected using my insulin pump. I used more insulin than usual, but not much more.

I spent hours relaxing in the pool, just sitting or sometimes chatting with other guests. With an insulin pump, you can take it off for up to two hours at a time, but I was often there for longer than that. The solution I found was to attach my pump to my cap, which also made for a good discussion topic 🙂 I just couldn’t quite stand up straight as the tubing was slightly too short to reach from the cannula on my tummy up to my cap lol.

 

One day, I was zoned out after a massage and went for a swim in the pool, forgetting to take my pump off.  Fortunately I remembered only about a minute into the swim and jumped out in a bit of a panic thinking I’d wrecked my pump (as I’d done to a phone before that never recovered).  It was fine, but certainly shocked me out of my zoned out state of mind!

I only had one minor hypo after going for a walk on the beach one day without notice, but it was only 3.6mmol/l and the juice box was cool from the mini-bar fridge so very welcome. I carried my hypo treatments and my BGL meter everywhere with me.

I went there with the idea of running my BGLs slightly higher than usual, okay since it would only be ten days away. I didn’t actually do anything to achieve that but the lack of exercise and higher GI foods naturally did it for me, and everything’s fine.

I remember the story of 90 year old, Edna who was diagnosed aged 20, so 70 years of diabetes, who said “I don’t worry about my diabetes, I just say to myself to do my testing, to get rest every day and to enjoy life and stop wasting time worrying about my health. If you look after yourself you will have a long, happy life like I have.”  Wise words methinks!

The language barrier

The Thai people are so lovely and helpful, but there were occasions when language caused confusion, such as the gluten free issue on the bus ride.  Also, I had taken 2 loaves of my low-GI GF bread and when we got there I asked the kitchen to put one into the freezer for me to keep it fresh until I needed it later in the visit.  Two days before the end I went to collect it and found they’d only kept it in the refrigerator, so it wasn’t as fresh as it could have been, but lasted the two days and the flight home so there was no drama.

I explained to the manager how asking for something to be kept in the freezer, meant the deep freeze where ice is made, not just the refrigerator, to ensure it is kept fresh. He seemed to understand so hopefully others won’t have this issue in future.

Happy Ending

The main goal of my holiday was to completely relax and switch off, which is exactly what I did. I didn’t even get around to reading any books. We just hung by or in the pool and the beach, had massages, ate yummy food, drank a few Mojitos (with little sugar and a big garden of fresh lime and mint in the glass) and lots of water, and chatted with other guests. I’m usually an adventure holiday type of girl, but to spend this relaxing time with my Mum was definitely what the doctor ordered.

We finished off with one day of adventure on rafting down a river on bamboo rafts, and trekking with elephants to make a perfect holiday. Wishing you all the opportunity to enjoy such a holiday yourselves one day. It was a once in a lifetime experience for me, but you never know what’s ahead!

 

Sally is owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too.