Traveling With Enbrel

What a challenge to need refrigerated medicine when you don’t have a refrigerator!  When I first started Enbrel, one of my scheduling considerations was finding an injection day/time that would minimize the need to travel with my weekly shot.  The perfect solution for me has been mid-week injections.  I don’t travel often, and when I do it’s usually a long weekend.  By avoiding Friday-Monday as the day to take my weekly medications, those rare excursions away from home have been easy.

Until now.  We just got home from a family vacation — a 5000 mile road trip.  Fortunately, I already had a medication travel kit because I requested one when my Enbrel was first prescribed.

My travel kit came with a lunch-box sized insulated bag, an ice pack that zips into a pocket in the bag, a small sharps container that also fits into the bag, and another bag full of alcohol wipes.  It was pretty nice to have everything I needed all together in a tidy little package.

There were a few glitches on our trip.

• Always make sure the hotel room’s refrigerator is plugged in and working if you’re going to rely on it to keep things cold for you.
• The fact that six hotels had a refrigerator in every room is no guarantee that the seventh hotel will have a refrigerator.  Ask before checking in.
• If it’s necessary to place medication in the hotel’s commercial refrigerator, use whatever excuse is needed to do it yourself.  I had one hotel clerk think that if there was an ice pack in my bag, he could save himself five seconds of work by placing the entire travel bag into the freezer instead of just the ice pack in the freezer and the rest of my stuff in the ‘fridge.  Lucky for me, he said, “I’ll just put the whole thing in the freezer for you” After a brief moment of panic, I convinced him to let me do the job myself.

And the big one:

• Refrigerator temperatures vary widely.  Some refrigerators are cold enough to freeze things.  Great if you have a bottle of water to keep cold all day in a hot car.  Not so good to remove your Enbrel from the refrigerator and discover that it is frozen solid.

Yes.  Saturday morning my Enbrel was frozen.

To say that I was not happy is an understatement.

Frantic

I contacted Enbrel Support and was informed that Enbrel should not be frozen.  I don’t often cuss, but I surely was tempted.  I didn’t try to freeze it.  All I did was stick it in the room’s refrigerator – which turned out to be extra cold!

I was then asked if I had a thermometer to check the temperature of the refrigerator.  Are you kidding me?  Who would pack a refrigerator thermometer in their vacation luggage?

Eventually the nurse read me what sounded like a prepared legal statement:  there is data to suggest that Enbrel that was frozen briefly in a household freezer (not a commercial freezer) can still be used after it thaws (just don’t do anything stupid like soaking it in warm water or putting it in the microwave).  Apparently people who are stupid enough to think that a refrigerator is a safe place to store refrigerated medication need to be warned not to microwave that medicine.

Who’s On First

Enbrel Support:  It should be okay, but contact your doctor.

Doctor’s Office:  Definitely not okay; contact Enbrel.

My doctor’s office, when I finally phoned, sounded every bit as concerned as I’d felt when I first discovered the frozen box.  They said, NO.  In no uncertain terms, the nurse said it would not be safe.  I should not use the frozen med and she offered me one of their samples.  Apparently the nurse only got the “frozen” part of the message, and not the “on vacation” part.  We talked some more, and eventually she said that she only knows what Enbrel tells her.  If they said it would be okay, I could go ahead and try it.

I can confirm what the support nurse said:  it doesn’t last as long, but it did work.

Next Time

I am now investigating the Frio that Helen recommended, and will report back.  It sounds like a better solution than the ice pack I used, and would have avoided the refrigerator/freezer issues entirely.