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We asked several infusion companies if they had anything to add to the article about traveling with home parenteral (IV) nutrition (HPN) that ran in the March/April issue of this newsletter. We were able to incorporate some of the comments into the original article (thank you Coram and ThriveRx!), but other comments were more involved or came after the article had been published.

Here we share the additional tips, to provide more ideas on making your travels successful. You can find the original article at www.oley.org (select the newsletter tab and look for the March/April 2018 issue), or request a paper copy at (518) 262-5079.

From Ann Weaver, Consumer Advocate, ThriveRx


The article suggests shipping your infusion pump, but I would be hesitant to do that because of risk of pump not arriving, or unexpectedly needing it due to flight delays. I instead would encourage consumers to carry pumps and at least one to two days worth of fluids and supplies with them, in case of unexpected flight delays.

Some companies routinely ship supplies at no additional cost to the consumer. The article suggests it might be possible to set up a relationship with a new pharmacy while you are traveling, but this may be difficult. Consideration would have to be given to the time required to do this, and insurance coverage would have to be confirmed beforehand. If traveling is important to you, it is worth exploring a home infusion provider that can accommodate your travel needs.

We have been told by TSA that you may not need to be patted down if you are attached to a pump, and that you may be able to complete a self-pat-down and have your hands wiped and tested. If you need to go through security hooked up to your pump, it is reasonable to ask if this is an option, but there is no guarantee you will be allowed to do so. Also, it is uncommon for TSA to review a physician’s letter in detail; a general summary may be sufficient, and your physician or home infusion company can help with this. (A more detailed health summary could be helpful if medical care is necessary while travelling abroad.) It is reasonable to ask TSA agents for new gloves when they are reviewing fluids in a bag, and to respectfully involve a supervisor if there are issues. TSA Cares will walk you through the screening process; many seasoned travelers have appreciated the assistance.

Consumers can familiarize themselves with the Air Carrier Access Act regarding carrying on extra medical supplies. (See www.transportation.gov/airconsumer/passengers-disabilities. The FAQs at www.transportation.gov/sites/dot.gov/files/docs/FAQ_5_13_09_2.pdf are helpful, particularly numbers 44–46.) It is my understanding that a person on HPN should be able to carry on medical supplies and is not limited to the two-bag carryon policy, so long as the contents of the extra carryon(s) is exclusively medical. Also, there should be no charges for checked baggage that is exclusively medical.

I encourage consumers to consider checking medical supplies at the gate (so you know they are on the same flight you are), and carrying on if you are not on a direct flight.

There were important considerations not mentioned about international travel. Typically, state and federal health plans do not offer coverage while travelling abroad and consumers should consider supplemental health insurance. Travel insurance and medical transport insurance are also worth looking at, especially when travelling to areas where level of medical care may be questionable. It may be helpful to include a copy of the HPN prescription and travel letter in supply boxes when travelling abroad; the home infusion company may provide these, and package them with supplies.

While it is suggested that HPN could be placed in a hotel kitchen fridge, I recommend keeping HPN in the room and having the hotel freeze ice bricks, which can replace the thawed ice bricks in insulated shipping boxes or coolers.

In her article about traveling from a consumer perspective (also in the March/April issue), Emily talks a bit about the dehydrating effects of air travel and how to handle that. That is a great point that should be discussed with a clinician before you travel.

From Michael Medwar, Patient Advocate, Coram CVS/specialty infusion services:


If you are traveling internationally, shipping may not be possible. You may need to carry all medically necessary liquids and supplies. Be sure to have documentation such as a doctor’s letter and a medical inventory to present to authorities at international airports.

While not required, making arrangements for special assistance from a TSA Passenger Support Specialist in advance of travel will usually help you have a less stressful, smoother experience when passing through security at U.S. airports. If you’re traveling with PN, don’t hesitate to contact TSA Cares with questions and to arrange this assistance.


From Penny Allen, RD, LDN, CNSC, National Director, Nutrition Support, BriovaRx Infusion Services:


One idea that was briefly mentioned that could save a lot of work and anxiety is the idea of using a premixed PN formulation for travel. Prior to planning for the trip, the consumer should work with their physician and home nutrition support team (infusion provider) to assess if there is a similar premixed manufactured product available to substitute for the duration of the travel, so refrigeration is not needed. These bags are easier to pack in a suitcase, and do not need any refrigeration until after they are activated.

Years back we helped a consumer go to London for a semester! It took months to plan with her physician, customs, Fedex, etc. but we switched her to a premixed formula while she was attending college in London. She was stable enough that she only need one or two blood draws during the semester so it worked out great that she got to experience a semester abroad. We also had a businessman for years who traveled regularly and we would switch him to a premixed manufactured formula whenever he had to travel. He just put the bags in his suitcase along with supplies needed and he was stable enough to skip lipids for a few days. The premixed packaging is also hard to burst or damage if packed correctly.

Another comment: insurance coverage (especially Medicare) may make it very difficult—or impossible—to switch infusion companies short term for travel purposes (and the infusion companies may not like it either). Consumers do not want to risk losing their insurance coverage, especially those with Medicare and the difficulty of meeting the stringent criteria in the first place.


May/June LifelineLetter, 2018

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This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.

 

Updated in 2015 with a generous grant from Shire, Inc. 

 

This website was updated in 2015 with a generous grant from Shire, Inc. This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.
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