I am back here again with a question. I am planning on going on a company assignment to Brazil for 6m to one year.I am using the Minimed 723 pump
I wanted to get some ideas from people who may have done something similar
1. How can I carry the amount of insulin for 6m. What can i do in case some vials break or go bad. Do you know if Novolog is available in Brazil
2. I am planning on taking my pump supplies with me for them to last atleast 6months.
3. How do I carry the insulin on flight. how can i keep it cold enough
I am also talking to my insurance, Endo and Medtronics to figure out the best solution. One thing i found out so far was that Medtronics Brazil will not honor any insurance plans from US as such. So in case I get supplies from them, I have to pay cash and the cost is twice as much as in US
Should be no problem, really. Note that a lot of drugs are WAY LESS expensive outside the US.
If you are going for your company, they should be able to provide you a letter that your insurance company will accept to give you 6 months worth of insulin. When you get to Brazil, put it in the refrig.
Carrying on the plane is also pretty much a non-event. I would carry it as part of my carry-on baggage - insulin doesn't need refrigeration for the relatively short duration of the flight.
If you want to carry it as part of your checked baggage, I would get a gel-pack that you can freeze and box it with the insulin. Stick it in your bag and forget about it. If the bag makes it your insulin will too :) .
When I lived on a boat for 5 years, a good part was spent in the Caribbean. When I needed supplies, I had them shipped to a friend/relative in the US, so I could still use my insurance plan. They would then ship directly to me, or if they were visiting, they would bring the supplies with them (who wouldn't want to visit you in Brazil?).
If you get a 6-month supply of insulin and/or test strips, just make sure you pay close attention to the expiration date and use appropriately. I did have a bunch of test strips that "expired" because the "use by" date was gone and the chip in the meter wouldn't let me use them or back-date the meter.
Again, with a little planning, it should be a total non-issue. Sounds like a great opportunity!
I'm interested in what kind of answers you get here. I just started MDI 1.5 years ago. My first big experience with 2 weeks of travel to Mexico/Carribean was a learning experience, I ended up with my insulin stock destroyed through accidental freezing (long story). In the end, I was able to get NPH and R readily. I didn't attempt to get newer insulin's. My experience in Mexico is probably similar to the situation in Brazil. In Mexico, you need to be careful about where you buy drugs. There are lots of corner stores with questionable drugs, but there are also new, modern and high quality pharmacies. You will need to be careful using local sources for things like insulin, there isn't the assured level of quality and control that is present in the US..
I have some update on this from my insurance.
As Mike suggested, they said ordering six months supply at once shouldnt be a problem as far as the endo agrees to do so. the only challenge is to carry it in the flight without destroying it. I also found out by calling some reputed pharmacies in Brazil and also Novo Nordisk (Novolog) that the same novolog is available in Brazil under a different name.
The idea of getting supplies ordered here and then getting them shipped is also great. I think my friends here will be able to do that.
FWIW, The endo/script was no problem.
I just had to make sure the endo wrote a prescription that was good for a year - "X units/day" until say, April 2013. My mail order pharmacy was the problem, because they ONLY want to fill 90 days at a time. I had to jump through MANY, MANY hoops to get 1 year's worth of insulin and test strips. Of course, I wasn't going for work, so you have a different kettle of fish.
I don't really see the carrying on the flight issue unless your TDD is huge. I think I ended up with something like 12 - 15 vials. I just kept them in a couple of one gallon Zip-Loc bags and slipped them into my carry-on bag.
I wanted to keep them with me so I could make sure they weren't subjected to any temperature extremes in the baggage handling arena (baking in the sun, subjected to high-altitude freezing, etc).
Okay, so I've been living in Paris for over six months and had to deal with all of these questions before I got here. Basically, I planned in advance and began to stockpile supplies and prescription so I'd have a 6-month supply WITH ME when I went abroad.
INSULIN: So my insulin prescription happens to be for 3 vials of insulin per month, but I only use 1, so I had stock piled a lot of insulin. I brought 12 vials with me (all that would not expire during my 8 months abroad). With regards to the flight, I brought a cooler, stocked it with freezer packs and did not open it once for the duration of the flight. I had A LOT of freezer packs in there of different sizes surrounding the insulin. It stayed cold! Got insulin into a fridge as soon as I got to my apartment and it's been good ever since.
2. I had stock piled a lot of pump supplies. I brought 10 months worth (for an 8 month stay) because I'm paranoid. That part was easy. I'm still going strong in this respect.
3. With regards to other supplies, the only thing I really couldn't stockpile was strips. Although, I did get my endo to increase my prescription for strips, so I could begin to stock pile a bit before leaving. I use Medco (mail order pharmacy) that fills my strip prescription for 3 months at a time. I got a 3 month supply right before I left. Then what's great about Medco is you can manage all your refills online. So after 3 months, I refilled my prescription had the strips mailed to my parents in the US (because it's a US prescription) and then my parents just mailed them to me in Paris. Sounds complicated, but actually really easy. I have a Dexcom CGM and do this with the sensors as well. (also, my Dad came to visit me in Paris a couple of months ago and brought some more supplies) I've been here 6 months and have not had to have one diabetes related prescription filled here the whole time.
4. Then other supplies, back up syringes, ketostrips, glucagon--these are the sorts of things you don't need TONS of, so if you just have some to take with you, you'll be set.
yeah, I needed a whole suitcase for diabetes stuff, but it was worth it for peace of mind! Just in case I got trouble from airport security I had a letter from my doctor explaining I'd be living abroad for 8 months and that's the reason for so much supplies, but no one asked to see it.
I'm sort of an expert in this field, so if you have any other questions at all, feel free to message me!
I think you've got some great advice here so far. Assuming you're a US Citizen, I would also suggest contacting the US Consolate/Embassy in Brazil prior to leaving, they might be able to help you in the event of an emergency. Even though it's in another country, it's considered part of the US for many purposes. Their website is http://brazil.usembassy.gov