Tuesday, June 28, 2011

Traveling or Camping with Enbrel

Traveling is so important to APL and me - and we really love to go camping - so when I first heard that Enbrel needed to be refrigerated, I felt my heart sink. I was really worried that it would make traveling - and especially camping - difficult or impossible.

But it is not impossible!! While I will admit that traveling or camping with Enbrel takes a little more thought and planning, it is totally possible. I have now traveled internationally to China, Australia, and Spain with my Enbrel safely in tow. And I've camped with Enbrel in Australia and all over the U.S.

Obviously you should talk with your doctor about the best methods of traveling with Enbrel. But, from my experience, I'd like to offer what I hope are a few useful pieces of advice about traveling with meds that need to be refrigerated:

Your Transport Container 
You should have a little insulated travel cooler specifically for transporting your Enbrel. You can get one for free from Enbrel Support (Call 1-888-436-2735.) In it keep:
  • As many doses of Enbrel as you need for your trip
  • An ice pack
  • Extra ziplock bags (for ice - I'll explain more in a minute)
  • Alcohol wipes (for injections)
  • I also like to take the box my Enbrel comes in - with my name and prescription information - in case I need to prove that it is medically necessary to the TSA (though that has never happened to me)
Flying with Enbrel
The Enbrel website says you should call your airline in advance to check about flying with Enbrel. I don't recommend this - when I called they had zero idea what I was talking about and couldn't seem to understand why I had called at all. Instead, here is some advice I have gathered through experience:

  • ALWAYS carry your Enbrel on the plane - it can freeze in the baggage compartment if you put it in your checked luggage.
  • At security, I used to take my Enbrel out and declare it to the TSA (which is what they request) but I don't bother anymore. Most of the time it goes right through security without a problem. Occasionally the solid ice pack will show up on the X-ray and they will want to look at it, but they always give it back. The TSA is required to let you carry medically necessary liquids on the plane, and Enbrel is a prescription.
  • For international flights (or flights longer than a few hours): 
    • When you board the plane, tell the flight attendant you have medicine that needs to be refrigerated and ask if you can put it in the airplane's fridge. I've never had a flight attendant say no to this request. (Though if they do, tell them you will need ice during the flight to keep your medicine cold.)
    • Don't just give them the Enbrel - give them the entire little cooler with the ice pack inside. Even if the ice pack melts on a long flight, if it is in the fridge it should stay cold long enough for you to find some ice or another fridge after you get off the plane.
    • When they put your Enbrel in the fridge, they usually want to know what seat you are sitting in. I usually attach my boarding pass to the outside of the little cooler.
    • Sometimes the flight attendants will bring your Enbrel to you right before the plane lands. If they don't DON'T FORGET YOUR ENBREL ON THE PLANE.
When You Have Access To A Fridge
Most hotel rooms these days have mini-fridges in them, so keeping Enbrel cold once you get there is generally pretty easy. Even if the fridge is a mini-bar, you can put your Enbrel in and take it out when you leave without getting charged anything.
  • Make sure the fridge is adjusted properly - cold enough, but not so cold that it will freeze your Enbrel.
  • BEWARE of fridges that turn off when you leave the room (I saw this in Spain and China). This is usually true in rooms where you have to insert your room key to turn on the lights. If you can leave an extra key in the room to keep the fridge on when you are gone, that should work. 
  • If there is no fridge in your room, or the fridge turns off when you leave, or you check out and are leaving your luggage for the day at the hotel, just tell them at the front desk that you have medicine that needs to be refrigerated. In my experience, the hotel has always been more than happy to put my Enbrel in their fridge.
  • If you aren't sure you trust the hotel or if there is a language barrier and you aren't sure what got communicated, ask to see the fridge so you can make sure everything will be ok.
When You DON'T Have Access To A Fridge
Don't panic!! Ice works just as well at keeping Enbrel cold!!
  • If possible, freeze your ice pack before leaving and use that as long as it is solid.
  • When you need ice you already have ziplock bags for it in your carrying case! When using ice I also like to double-bag it and/or put the Enbrel in a ziplock bag too to prevent leaking when the ice inevitably melts.
  • You can ask for a small amount of ice anywhere that uses ice - cafe, gas station, coffee shop, bar, hotel. We always offer to pay for the ice, but we have always gotten it for free when we tell the employee that we just need a little bit of ice to keep some medicine cold. In our experience when we hand over a ziplock bag, it gets filled with ice for free.
  • REMEMBER: when using ice to keep Enbrel cold, it is important to check on it every couple of hours to see if you need more ice.
  • Another option that works especially well for camping or driving is to get a little cooler that is charged through the cigarette lighter in your car (that's what we did in Australia). Just make sure you don't kill your car battery and that the cooler gets cold enough!
And that's all I can think of!! It seems like a lot, but I promise it is really not that bad. I was pretty nervous the first time I traveled with Enbrel, but now it seems like second nature. And we still get to travel. ~;o)

14 comments:

Deb aka murphthesurf said...

Wonderful advice! I used Enbrel for years and traveled with it too! I used almost all your suggestions and I never had any issues either. Great blog post for current Enbrel users!

~Mariah~ said...

DEB: Thanks! I generally try to stick to telling my own story and stay away from giving direct advice, because everyone is so different and how they manage their RA is different, but I couldn't resist here. I wish I had known all this when I first got put on Enbrel and faced traveling with it for the first time...and I hope others will feel the same way.

Melissa said...

Really good advice for those traveling with medication that needs to be refrigerated!

~Mariah~ said...

MELISSA: Thanks! If you can think of any more good advice I'm happy to keep adding to this list!

Melissa said...

So I had to go come back to this post because I'm currently in the process to get switched over to Enbrel (have to have some tests and shots and with the holidays, it'll take forever). I'm going to have to get a little cooler for the Enbrel for travelling!

~Mariah~ said...

MELISSA: Good luck with the Enbrel - it worked WONDERS for me! Also, if you call Enbrel Support (1-888-436-2735) they'll send you a free travel pack. ~;o)

Martha said...

Thank you for this post, it's VERY helpful! Two questions:

-- Do you worry about the ice in the pack freezing the Enbrel? I'm not sure where the line lies between cold and too-cold.

-- I had it recommended to me to put a thermometer in the travel case so you can check whether it's at the right temperature. Have you done this, and if so, do you have a recommendation for what kind?

~Mariah~ said...

MARTHA:

I never worried about the Enbrel getting frozen - I don't think a regular ice pack or bag of ice gets cold enough to do that. Dry ice might get cold enough though, so I wouldn't use dry ice.

I never used a thermometer - I just do my best to make sure the Enbrel is on ice or in a fridge. The way I think about it is this: when I'm traveling or camping I do the best I can to keep the Enbrel cold but also enjoy myself, and I think if I was worrying about a degree or two on a thermometer I would be anxious and not having fun. So I choose to just try to relax and do the best I can. But that's just me. If a thermometer would make you more comfortable, I'm sure just a regular drug store variety would do the trick.

Please let me know if you have any other questions!! ~;o)

John Brownlee said...

A great video about traveling with Enbrel ... http://www.clear.md/ronankavanaghmd/vidscription/enbrel-information-pack/

Subhendu said...

Thank you ...Very useful.. God Bless..

Ronald Yudo Adityo said...

Hi Mariah,
In few months I have to travel to China for business trip from NL.

Can you share your experience with Chinese airport security as Im afraid it will be hard to explain it to them if they are not used to this.

Moreover since the city in China is about 2h from Shanghai by train & Im going for 1month, Im planning to bring WAECO TROPICOOL TC-07 with me. Its a 7L thermo electric, and since it is smaller than cabin luggage Im guessing it would be fine to carry.

Now the question is, do you think I can ask the steward or stewardess to plug-in the cooler to electric outlet (if any), or can I ask them to frozen my blue-icepack for me to use every few hours (since it takes +- 15h to 18h flight).

Thanks

~Mariah~ said...

RONALD:

I didn't have any trouble with Chinese airport security - I put my Enbrel carrying case with the ice pack through the X-ray and I wasn't asked any questions about it at any of the airports I visited. If you are questioned, I would just explain that it is medication that needs to be kept refrigerated. Perhaps ask for someone who speaks English if possible? If you are still concerned about it perhaps ask your rheumatologist for advice? Or call Enbrel Support?

As for the flight, when I take a long flight I always ask the flight attendant if I can put the Enbrel in the plane's refrigerator - and they have always allowed me to. I have done this on planes to China, Australia, and Spain. For the 2 hour train ride a fully frozen ice pack should hopefully be enough to get you through.

Please let me know if you have any other questions you think I can help with! Have a good trip!!

Ronald Yudo Adityo said...

Thank you for your reply Mariah.
For safety reason maybe I will ask Pfizer to send me if they have the information written in Mandarin.

The reason im bringing Thermo electric is because im just afraid for some unpredictable thing, like delays, waiting etc. Ive been to China 3 years ago and at least it wouldnt be hard to find electric plug in the airport / bus / train station.

As for the inflight, Im glad to know we can put it in the airplane fridge.

Thanks again

David Jones said...

A great way to travel with Enbrel is with the Medactiv iCool Bag.
Also their new iCool MediCube keeps medication at the right temperature for 36 hours.
www.medactiv.com.au