Insulin on board?

[jocelysue]

Muffin started a great thread about coumadin on board which will benefit many cruisers I'm sure.

 

My question is aboutinsulin. DH started using insulin this week because his physician decided that Avandia ,which had kept his diabetes under control was no longer the appropriate medication because he had had bypass surgery.

 

We have an Ocen View cabin on the Rotterdam, thus no refrigerator. We used an online TA, and not HAL. From reading this board, it would seem that one can rent a fridge. On the other hand, it seems that the fridge is not very cold. Also there seems to be special disposal to be done which neither our pharamcist nor physician has told us about.

 

When DH questioned his MD about precautions, etc. , his physician told him that he was a grown man responsible for himself and that it was up to him to decide whether or not cruising was for him and whether he felt well enough to go. Needless to say , this was a quite unsatisfactory answer but family doctors (and specialists, even more so) are hard to come by, so we cannot easily find another doctor (We've been trying for more than a year)

 

DH has decided that we are going, but is quite worried about what he should do about the insulin. Whom should he contact to make sure that his insulin is stored properly? Is it our steward once we are on board, is it the ship's doctor, is it ourselves via a Fridge?

 

Would it be better for us to contact HAL ourselves or should we try via our TA (company, not person)?

 

Thank you for your answers. Surely, many others have the same problem and have found the appropriate solution. TIA for sharing.

[sailinglisa]

Personally, I would call the special needs department at HAL. Tell them your husband is an insulin-dependent diabetic and that he will need a fridge in the room to keep his insulin and will also need a sharps container for disposal of used syringes and lancets. The mini fridges are coolers and will keep the insulin cool enough.

[jocelysue]

thanks Sailinglisa. Is there a dedicated number for the special needs department?

 

I have no idea what a sharps container is nor does DH. Is it something special? Sorry for appearing so stupid but sometimes the terminology is different from the one we use here; other times we simply don't know (LOL) what people are referring to.

 

TI

[sailinglisa]

A sharps container is a red hard plastic container (I have seen them both round and square) that are used to put used insulin syringes in to prevent needle sticks by people handling used syringes. I don't know what they might be called in another language.......they do say "Biohazard" on them.

 

I know there is a dedicated number to HAL Special Needs, but I do not have it, sorry.

[richmon]

My wife is Type I, a Juvenile diabetic for 38 years. Needless to say, we have lots of experience in traveling with insulin.

 

Firstly, all meds should be in original containers and kept in carry-on luggage. It is best to have a prescription for all meds in case of emergency. Can save money and the hassle of finding a MD to write a new script in a foreign port.

 

At all times carry a list of your prescriptions with you. Give a second copy to your main travelling companion and drop off a third copy at the ships infirmary.

 

Regarding insulin, it does deteriorate in high tempertures but does fine in average room temperature. The bottle(s) in use should be fine in the cabin as should any others. If your dose schedule requires carrying it into port, a small insulated bag with a few ice cubes will suffice. NOTE: bring a small zip-loc bag from home and place the ice in it. Do not surround the insulin vial with ice; you don't want to freeze the insulin just keep it cool.

 

Most importantly, take only a few syringes with you into port and do have your presciption with you! With syringes being used to inject illegal drugs the possibility exists that one could be detained or arrested by local authorities on suspicion of illegal drug use.

 

I am surprised that you were switched to insulin from Avandia. Here in the states most MDs are recommending either Byetta or Jenumet. I will be starting on Byetta this weekend. It also has the advantage of reducing appetite and therefore resulting in weight loss. Definitely a plus in Type II diabetes. BTW, I do work in healthcare.

 

Hope I have answered the question to your satisfaction.

[thomasale]

I am on novolog and levemir. Both of these analogs (synthetic insulins)can be kept at room temperature for at least 10 days (i have kept them up to 20 days with no decrease in effectiveness.) These are great because they come in injectable pens that carry about 300 units each.

 

What types and times of insulin is your husband taking?

[shonuf]

Regarding insulin, it does deteriorate in high tempertures but does fine in average room temperature. The bottle(s) in use should be fine in the cabin as should any others. If your dose schedule requires carrying it into port, a small insulated bag with a few ice cubes will suffice. NOTE: bring a small zip-loc bag from home and place the ice in it. Do not surround the insulin vial with ice; you don't want to freeze the insulin just keep it cool.

 

.

 

I ordered an insulin carrier from an on-line source (google for insulin carrier) and it has a couple gel packets that you can freeze and it will keep the insulin cool while you travel. I kept the packets in the refrigerator on the ship and they were still cool enough to do the job on the way home. Be sure to put a note on the refrigerator door that you have insulin inside so that the steward doesn't lock the door on the last day after he does his beverage count!

[Cybercsp]

We have traveled on cruises with my son, who is insulin dependent, although not on HAL. We request a "sharps container" from the room steward when we arrive and have never had any issues in obtaining one. My son's endocrinologist has told us that his insulin (Novolog) will maintain its integrity at room temperature for a month. We have a pouch with a gel pack (similar to what has already been described) that he carries if we are off ship in very hot climates. With time changes, new foods, etc. we find that frequent blood glucose checks are very important to prevent complications. He has done very well with travel. Remember to bring extra supplies and hand carry everything you will need. Have a great trip!

[jtl513]

I have no idea what a sharps container is nor does DH. Is it something special?

If you go to www.froogle.com and search for "sharps container" you will find a wide variety ranging from $3.50 to almost $80. You should get something for home use, but if the ship can supply them, as Cybercsp just said, there's no reason to bring your own along.

[trubey]

I travel with my insulin -- both Lantus (long term) and Humalog -- all the time.

 

The Humalog is in a pen, a syrette with 300 units: and the Lantus is a normal injectable from a bottle. My MD said either one is good for 30 days or so unrefrigerated. Don't sweat the small stuff!

 

Congratulations on starting to shoot up. (Only the best people do, as my type-1 son says) With the orals, you have to watch your diet like a hawk. With injectable, see that piece of birthday cake? Add 2 units and you're good to go!

 

Lane

[temple10]

Hi Jocelysue,

I also had gastric bypass, and at 8 months out I no longer needed my meds for my diabetis, any chance for your husband? I am sure they will understand your medical concerns and find a way. Christine:)

[Cruisin'Nurse]

I have done a number of cruises while on insulin and have never refrigerated the insulin - and have never had a problem with it. I always pack a small empty metal coffee container to put my "sharps" in. They have plastic lids that fit fairly tightly. That way if the room steward can't supply one of the usual containers - I have the metal container as a back up. It has always worked well for me. Have a great cruise!

[cp556]

The cruise line WANTS to know medical conditions of its passengers. The onboard dr then knows he has "x" heart patients, "y" insulin-dependent diabetics, etc.

I agree with the previous posters ... pls call HAL and speak with the Special Needs Dept or Medical Desk ....

[jhb32]

Responses are all good. I am insulin-dependand now in my 57th year. Have 184 days on HAL and over 50 more on Princess and Mississippi Queen. Have traveled with insulin and syringes from days when syringes were glass and needle were not disposeable and was necessary to sterilise and re-use them. It is possible to live and travel with diabetes. I might add - I also carry a BD clipper (available at most drug stores) to snip ends of syringes off - makes dispsal safer for everyone.

[jocelysue]

Thanks ever so much for your very helpful ansers. DH sometimes tells me that I spend too much time on CC but this mornized he was pleasntly surprised - amazes even - to see how truly helpful people are.

 

DH has Novolin ge 30/70 penfill. On the box it is specified that it should be refrigerated between 2 degrees and 10 degrees Centigrade. He is supposed to take 4 units every morning.

 

This is all new to us. Believe me, he would much prefer taking medication but his MD will not refer him to an endocrinolgist. When DH asked for a reference this was the answer "If you don't have confidence in me, find another doctor". Now that's an almost impossible feat.

 

However, he is much relieved because of your answers and encouragement. He even told me to print a copy of your answers and suggestions. So once again, thanks a lot.

 

Will be leaving tomorrow until Tuesday after Labour Day. Not sure if we'll be able to access the internet. However, your answers are comforting . Please keep them coming. Will reply whenever I'm able.

 

Happy sailing everyone.

[sijid]

My husband uses Byetta, and we found this thing called a Frio: http://www.diabetesandmore.com/detail.aspx?ID=227

 

He loves it. It keeps his drugs cool under all circumstances, and doesn't need ice or anything.

[Cruisin'Nurse]

Jocelysue - I am appalled by the attitude of your physician. Is the inability to transfer to another MD a result of your medical system? What a nightmare! There are many websites with good diabetes information. You may have to use them to get information since it seems your doctor isn't going to be very helpful. I would recommend the American Diabetes Association website as a place to start. Best of luck!

[Typhoon1]

Thanks ever so much for your very helpful ansers. DH sometimes tells me that I spend too much time on CC but this mornized he was pleasntly surprised - amazes even - to see how truly helpful people are.

 

DH has Novolin ge 30/70 penfill. On the box it is specified that it should be refrigerated between 2 degrees and 10 degrees Centigrade. He is supposed to take 4 units every morning.

 

This is all new to us. Believe me, he would much prefer taking medication but his MD will not refer him to an endocrinolgist. When DH asked for a reference this was the answer "If you don't have confidence in me, find another doctor". Now that's an almost impossible feat.

 

However, he is much relieved because of your answers and encouragement. He even told me to print a copy of your answers and suggestions. So once again, thanks a lot.

 

Will be leaving tomorrow until Tuesday after Labour Day. Not sure if we'll be able to access the internet. However, your answers are comforting . Please keep them coming. Will reply whenever I'm able.

 

Happy sailing everyone.

 

 

With a response like that, I would take his advice and find a new doctor. This guy sounds like a total ***hole

[MSammy]

My daughter is 22 and has been a type 1 diabetic since age 9. Her advice: keep your unopened insulin in the fridge. Once you open it, keep it at room temp. Only if it goes above 98 degrees do you need to worry--some types of insulin will crystalize at that temp. You should be fine without fridge.

[Juanita462]

There have been articles in the paper about Avandia causing heart disease and that seems to be giving doctors the idea of being cautious and replacing it with something else - in this case insulin. Too bad your

doc wasn't more informative - if that was his reasoning.

 

The articles said that they weren't going to remove it from the market yet but would be waiting for further studies.

[SteveBear]

A "safe-clip" device, made by BD (http://www.bddiabetes.com/us/main.aspx?cat=2&id=416) is definitely less cumbersome than a sharps jar. In my experience they're more likely to be carried by an independent pharmacy than by a chain drug store.

 

Storing synthetic insulin in your cabin at room temperature for a week or two is no problem. Given the injection quantity you mentioned, you probably won't need more than one vial anyway, unless you're doing something like a world cruise.