Travelling with Byetta


[Also what to do if the power goes off for an extended period!!!!!!!!!!!]

Travelling with Byetta that has to be kept cool is a problem that worries many users.

Extreme temperatures at either end of the spectrum, either overheating or freezing, will mean you have to throw your expensive medicine away as it is no longer viable.

We used to be told that Byetta had to be kept in the fridge throughout it's life but,

Amylin have now issued new and much more convenient guidelines.

1. A new, unused pen must be kept refrigerated, not frozen, at 36 to 46 deg F (2 to 8 deg C) and also protected from light.

2. Once you have started using the pen you can keep it at room temperature BUT only if the temperature in your room is less than 77 deg F (25 deg C) and more than 36 deg F (2 deg C).

So those of you who live in hot climates where the inside temperatures can go well above this will still need to keep it refrigerated.

Conversely, if you live in a very cold place where the inside temp drops below 36 deg F (2 deg C) ( brrr!!) you will still need a fridge to stop it from freezing.

Whatever the temp remember to protect it from light.

3. When travelling with the pen you must be sure to keep it both dry and below 77 deg F (25 deg C).

There are various types of coolers that you can buy to help you keep your Byetta cool.

DO NOT buy the ones that are sold to keep insulin cool if you are looking at travelling with an unused pen.

Insulin does not need to be kept as cold as Byetta does so the coolers designed for insulin will not maintain a proper temperature for Byetta.

You must make sure your cooler is able to maintain temps between 36 to 46 deg F (2 to 8 deg C).

Lets look at some of the coolers available.

Byetta Travel Pack

This is the Travel Pack that Amylin/Lilly presently supply free to new Byetta users - if you know to order it that is! It is apparently available by coupon in some starter packs but usually one only finds out about it from another user.

To order it phone the US Amylin/Lilly Customer Support Center toll-free at 1-800-868-1190.

I believe it is also possible to order it online.

This is not a 'long trip' solution. At best it will only keep your Byetta cold for 1 1/2 to 3 hours, depending on the outside temperature.

It is, however, very useful for taking your pen to and from work, so long as you can refrigerate the pen at either end.

It also comes in handy when going out for dinner, when you will want to give yourself your injection within the hour before you eat, as it is smaller and more discreet that many other coolers.

Innovative diabetics have come up with a way of altering these travel packs so they last longer.

One suggestion is to remove the gel packs that come with the pack and replace them with the following:-

Cut 8 squares of bubble wrap, (the type with small bubbles), the same size as the removed gel packs.

Put 3 of these on top of each other, then place 3-4 frozen artificial ice cubes (or a strip of the flexible ones if you can get them) on top, followed by another square of bubble wrap.

Slip this into the one side of the travel pack, from where you removed the gel packs, with the single layer of bubble wrap towards the inside. Repeat for the other side.

As long as the outside temperature is below 80 deg F ( 27 deg C) this should work for up to 6 hours.

The Frio wallet

The wallet is made up of panels containing crystals that, when immersed in water, become a gel. The water that evaporates from this gel over a period of time keeps the wallet and it's contents cool for around 45 hours.

The Frio works even better if the water you soak it in is really cold. You can use ice cubes to cool the water quickly. Do not freeze it though.

These are very popular with insulin users but, because they only maintain temperatures of between 60 to 72 deg F (16 to 22 deg C), were considered of no use for Byetta users who needed to keep their supplies at 36 to 46 deg F (2 to 8 deg C).

However, since the new guidelines for Byetta have been issued it would appear that as long as the pen you are trying to keep cool is already in use it will work okay.

The Frio Wallet will keep the opened Byetta below the cut-off point of 77 deg F (25 deg C).

However it WILL NOT WORK as storage for a NEW UNUSED PEN, which must be kept at 36 to 46 deg F (2 to 8 deg C).

Frio Wallets can be bought from

friouk.com/ in the UK

diabetesexpress.ca in Canada

coolerconcept.com in the US

medica.co.nz in New Zealand

 

MedCooler

Made by Polar Bear Coolers these claim to keep your medication at an average temperature of 40 deg F (4 deg C) for up to 24 hours and even if it is 100 deg F (38 deg C) out there they will still maintain a temp between 34 to 56 deg F (1 to 13 deg C).

They come in 2 sizes:-

The Small MedCooler with an external dimension of 10" x 7" x 7" and a medication storage area of 7.5" tall x 2.5" in diameter. Cost is around $45.00.

The Large MedCooler with an external dimension of 14" x 12" x 7" " and a medication storage area of 8"x 5.5"x 3". Cost is around $55.00.

As you can see from the dimensions these are not something you can tuck into your handbag. In fact they look very much like the cooler bag one users for a 6 pack of beer or colddrink.

They are made of a strong material, known as Cordura, and closed cell foam which has great insulating powers. They come with 2 PolarBear "Techni-Ice" packs.

Folks that have used them say they work very well.

They are available from

Polarbearcoolers.com

 

Medicool

Medicool make a number of different coolers but most of them are for insulin.

However they do sell one for use with Byetta. This is the Medicool ProtectAll with special Blue Cooler.

It is the special blue insert that make the difference. You freeze this for 8 hours, let it stand at room temperature for 10 minutes and then put the Byetta pen in it.

Eight seems the magic number when talking about this product because it will keep your Byetta cool for around 8 hours.

It is not cheap at $44.95, or around $55 with shipping, but it is a 'one time' purchase and people who have tried it say it works very well.

It is also made of Cordura and is in the shape of a large fanny pack. Wearing it as a fanny pack can be a bit uncomfortable because the hard Styrofoam insulation makes it a tad rigid.

It has extra compartments and pockets in which you can put some of ones other diabetic paraphernalia.

Available at

medicool.com

 

Micro Cooler

This is a new product from Medi-Fridge which will take a single Byetta pen.

It contains a specially designed reusable ice pack that they claim will keep your medication cool for up to 20 hours. For the first 10 hours it will keep the temp between 36-46 deg F (2 to 8 deg C), after that the temp will slowly rise to around 75 deg F (24 deg C).

So for 10 hours at least it could even be safe for an unused pen while for a pen that you are using the full 20 hours would be okay.

For a price of around $18.98 you get a lightweight, 8" x 3 1/2" x 5" insulated travel bag with 2 of the re-freezable ice packs.

These are sold by

insulincase.com

Amazon.com

 

Micro-refrigerator

This has been specially designed by Medi-Fridge to keep injectable medicines at a safe temperature.

It is portable and can run either on your standard AC (house) current or on DC ( 12 volt battery, as in your car).

Remember that if you are using it in your car it will continue to draw power even when the ignition is turned off so will eventually drain the battery in exactly the same way as your headlights will if you leave them on.

It is simple to use as it has no external temperature controls that you have to set (and where mistakes can be made). It turns on automatically when the temp gets to 50 deg F (10 deg C) and shut off automatically when it gets down to 40 deg F (4 deg C), so there is no chance of your Byetta freezing or over-heating.

It runs much quieter than other portable mini fridges.

It's one drawback is that it will only take a single injectable pen.

It sells for around $49.98

The Micro-refrigerator is available from

medi-fridge.com

insulincase.com

 

Unisar Portable Mini-Fridge

This is an electric fridge that run on mains or battery power. It is larger than the above mentioned Micro-refrigerator, being able to house a six pack of cold-drink cans.

It will get the temperature down to around 41 deg F (5 deg C) if the ambient temp is in the 80 deg F (27 deg C) range.

It is also able to heat and has an external Hot/Cold switch, so to prevent accidents happening it is a good idea to put a piece of tape over the switch once you have set it to 'Cold'.

It has been reported as being "quite noisy" so is not the ideal bedroom companion.

It costs around $50-$60 though cheaper ones can sometimes be got on ebay.

However.....

Some people have experienced difficulties with this unit. As soon as the ambient temperature went above room temp (around 74 deg F or 23 deg C) and/or the humidity went over 50% the unit would drop the temperature below 32 deg F ( 0 deg C) and freeze the contents!


That deals with the bought coolers. Now for the one that diabetics have sussed out for themselves.

The Briefcase thermos method

Supplies you will need...

A 1/2 litre (16oz) stainless steel briefcase thermos. These are about 10 inches tall and 3 inches in diameter (25 1/2 X 7 1/2 cm).

(It MUST be this type which does not have a glass insert.)

Some re-sealable plastic bags. Sandwich size will do but the larger (quart) size ones are stronger and better. These stop the pen from getting wet.

Small piece, about 6 inches (15 1/2 cm) square, of bubble wrap.
Rubber bands.

Ice cubes - (NOT the artificial kind). As fresh ice cubes come in all sorts of different sizes you may have to experiment a bit to get the right ones. Breaking larger ones down into smaller pieces or using crushed ice is okay, though crushed ice melts faster.

Method....

Put 3-4 ice cubes into a sealable plastic bag, seal, roll the bag up from bottom to top and keep it closed with a rubber band.

Place the bag of ice cubes into the thermos so that it is standing on one end.

Carefully roll your Byetta pen in the piece of bubble wrap (makes sure that the does not touch the ice), put that into a second sealable plastic bag, seal and roll up exactly as you did the ice cubes.

Again use a rubber band to keep it rolled.

Put this bag into the thermos next to the ice cube bag, also standing on it's end, with the blue cap end at the TOP of the thermos. This is very important.

Screw the thermos stopper in tightly.

Your improvised cooler is ready to go.

Folks who have tried this method and have written into the forums about it have found that at room temperature it will maintain their Byetta at the correct temperatures of 36-46 deg F ( 2 to 8 deg C) for 24 hours and even longer.

One gentleman stated that in a closed vehicle at an ambient temp of around 90 deg F (32 deg C) it still worked for around 16 hours!

The beauty of this method for long distance travel is that there is usually somewhere that you can get fresh ice from to replace the stuff in the thermos once it has melted.

Normally it is available from hotels, restaurants, supermarkets, convenience stores, pubs, on airlines and cruise ships etc.

Also when you are flying you often cannot get the flight crew to refrigerate your medication but they will give you ice.

The reason for not using artificial ice cubes is that they need re-freezing once melted and often there is nowhere to do this. Even places that have fridges may not have freezers - your hotel 'hostess' fridge for example.

If you are worried about whether your thermos is keeping the right temp you can buy a thermometer, known as an 'stream fly fishing thermometer' from places that sell fly fishing equipment or order it on the web.

The one you want is a pen shaped thermometer with a length of around 6 3/8 inches (16.3 cm). Most will read in a range from -20 to 120 deg F (-30 to 50 deg C). Good ones are made from metal.

In the States one can buy them from Bass Pro shops or on the web at

basspro.com (Bass-Pro catalogue item #38-489-400-00) for $8.95

and in the UK from fly-fishing-tackle.co.uk for £5.82 or orvis.co.uk for £10.50.

(Prices subject to change!)

These thermometers will fit inside the thermos. You just slide them between one of the rolls of the plastic bag wrapped around the pen (NOT the ice cubes).

One advantage of these thermometers is that they are allowed on planes whereas the digital ones are often not as they have a spike that the authorities feel could be used in a similar way to an ice pick - ouch!

Digital ones can be useful for checking the temperature of your fridge however - not all the fridges that hotels agree to put in your room will actually maintain the temperatures Byetta needs.

It does not matter in what position this thermos is when you are travelling. Either upright or on it's side, the temp will remain stable.

Flying with Byetta

All the new restrictions to ensure our safety have not made this easy for Byetta users. Unfortunately, because it is so new, airline staff have never heard of it. Some folk do not bother to explain but just say it is insulin. Others feel that we need educate the officials about Byetta so explain what they have and that it has to be kept cool.

One cannot put ones Byetta in the hold as the temperatures there can drop below freezing so you need to carry it on the plane. At one time many planes would not allow you to take gel packs or any liquids aboard - despite recommended guidelines it actually seems to depend on the security staff at each individual airport.

Folk have still been able to carry their pen in the thermos but have emptied the ice out before going through the checkpoint then refilled it from one of the airport bars or on the plane itself.

It has been suggested you put the thermos and any other diabetic supplies in a separate tray, tell them what they are and let them x-ray it ( X-rays will not hurt the Byetta).

Sometimes you will get through like this, other times you may be asked to open the thermos and let them examine it - no problem.

As restrictions have been lifted gel packs for medical supplies are supposed to be allowed but there is always one........!!!!!

Remember to carry a letter from your doctor stating that you need these supplies and that they have to be kept cold, but not frozen. Also have the original box and prescription label from the pharmacy with your name on it.

See our pages on Travelling with diabetes.

There is also a very good blog with advice on travelling with Byetta at

diabetesmonitor.com



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