What actually happened on September 10th, 2017? Why did I suddenly crash towards an adrenal crisis? Though the end result was positive (all TSOs are going to receive information on Adrenal Insufficiency), the actual event was terrifying.
After a thorough analysis of the episode, I was able to trace back the what and the why to a few key items that compounded upon each other. Any of the items in isolation would have not been an issue. But stacking them together allowed me to introduce myself to some rather nice paramedics.
Let us start out with the what.
1. The Water
I normally drink an entire 24oz bottle of water while standing in line for security. This trip, I had forgotten to fill up my water bottle before my drive to the airport. I was starting out the adventure water deprived.
2. The Wait
I always request to opt out of the scanners. I do not feel comfortable sending my cortisol pump through the scanner, no matter how many TSOs tell me that it is “safe.” Nope. Sorry. I also do not wear my cortisol pump on roller coasters. It is a personal choice I make and I understand that opting out requires a pat down search.
When I formally opt out, they must call for “female assist.” I requested to opt out and was told to stand over to the side. There was discussion between what to do next. One agent looked at another and asked, “So… do I need to call a female assist?” It took several minutes for them to notify the other TSO’s that a female assist was required.
3. The Trainee
When they finally found someone to complete the pat down, I realized I would have a trainee and a seasoned TSO. A trainee normally implies a longer screening processes, as they are still learning the routine. I was already out of water, had waited longer than expected, and now my screening processes would be slowed down even more as the trainee verified that she performed each step correctly.
4. The Suitcase
My suitcase was flagged and pulled aside for secondary screening due to a large stack of papers. My suitcase was locked, but I provided the unlock code. The male TSO could not figure out how to open my suitcase. Some TSOs request that the owner of the luggage unlock it to speed things up. However, the seasoned TSO scolded me for attempting to speak to the male TSO about how to operate my lock.
The seasoned TSO opened up my suitcase after the male TSO struggled for several minutes. I was starting to not feel well at this point, but I tried to remain pleasant. I also tried to look at the screens showing my x-rayed suitcase. Once again, the seasoned TSO felt the need to prove her “authority.” She informed me that observing the screens was forbidden.
That is inaccurate. I am not allowed to ask the TSO what they are looking for, or to ask them to explain the items seen on the screen. I am allowed to silently observe the screens as they determine that a stack of papers will not blow up the airport.
5. The Pump Site Location
Before beginning the pat down, a TSO will ask if I have any sensitive areas. I state yes, due to my medical device. I request that they do not touch my infusion site. They often tell me to place my hand over the sensitive area so that they will not accidentally touch it. I instinctively placed my hand over my infusion site without prompting for the trainee.
This irritated the seasoned TSO because she saw it as another attempt to undermine her “authority.” We got into an argument with raised voices. She told me I could not tell her where she could and could not touch me. I told her that she was not to touch my medical device for my medical condition.
I figured as a valid compromise, I would show her the infusion site, and thus showing her I had nothing to hide. I was not trying to cheat the screening, but I did not want anyone touching my infusion site. I lifted my shirt partially and exposed my stomach.
That did not appease the seasoned TSO. She continued to emphatically argue with me that I could not pick an area for her to not touch. As the situation intensified, I realized that things were not going to end well for me. I wanted to prevent further escalation, but it was too late.
I explained the rest of the episode in my open letter to the TSA.
The TSO that was sent to fetch me water brought back two water bottles. Both were supposed to be for me, however he decided to open one for himself. I needed that second water bottle and it was obvious that he was not supposed to drink it. They made him go and purchase me a liter of water from the nearest store.
There was also an issue with retrieving my medicine from my purse that was located inside of my suitcase. I clearly stated “The meds are in the purse in the suitcase.” The male TSO agent had no comprehension of the word “purse.” Another agent had to finally point out to him what a “purse” was.
I am incredibly thankful for the intelligent paramedics. They were surprised that they were called in. I knew exactly what I needed. I knew exactly where it was. All the paramedics did was repeat exactly what I said to the TSOs. However, the TSOs listened to the paramedics. They did not listen to me.
Once I cleared security, the paramedics took my blood pressure and my heart rate. I was tachy, with a heart rate greater than 160BPM. My body had been dumping adrenaline, but I had no ability to calm it down due to TSA withholding my cortisol.
The paramedics were apologetic. They stated that TSOs are trained to treat “not normal” as “high security threat.” Unfortunately, I have a disease that makes me not normal. I also have a disease that is hard to explain in a short amount of time to people unwilling to listen.
They validated that I did everything correctly. They also were appreciative to learn more about adrenal insufficiency. They had read about it in their textbooks, but I was the first person they met. They would not forget the experience. I was cleared to fly.
But why did I crash? I have the cortisol pump. I was giving myself boluses through the cortisol pump as soon as I realized that the seasoned TSO was going to make my life incredibly difficult. Yet I did not stabilize until the oral meds hit my system. What made the pump ineffective?
A Failed Pump Site
The next day, I changed my pump site. It was what we refer to as a “bleeder.” When there’s blood in the line, there’s no knowledge of how much medicine is actually being absorbed by the body. In this particular case, not enough.
This was not an old pump site. I had changed it before I headed to the airport. It was only a few hours old. I also have not had a bleeder like this in many months.
When in doubt, change it out.
I should have changed my pump site at the airport immediately after my crash at security. Instead, I delayed the change for an additional twenty-four hours.
We pumpers can become rather obstinate when it comes to inappropriately rationalizing a bad pump site. This has the potential to get us in big trouble. That failed pump site caused me to take a large amount of oral medicine to stay functional.
If my body had been absorbing my medicine normally through the pump, I’m sure I would have had no issues going through security. However, because of this episode 47,000 people will receive a briefing on Primary Adrenal Insufficiency. I am still unbelievably humbled by that outcome. May it enable others to remain Clearly Alive.