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1 - Has anyone actually used the MediCool ($44) travel case yet? I know JOHN got one. Mine came yesterday. I was previously under the impression that the freebie case that is good for 2 hours would fit inside but it is not designed that way. I am afraid toactually freeze the pen holder insert and have it refrigerated. It is hard to believe that with a refrigerated insert the spit would keep for 12 hours but maybe that is due to the high class styrofoam. Do you agree anyone?
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2 - I got mine just about 3 or 4 days ago and have started taking it to work with me to get my evening shot before I come home (I work late). It works great. I tried the free one from the Byetta folks for a couple of days and within 3 or 4 hours it is getting warm. The pen coming out of the Medicool one after 6 or 7 hours will be just as cold as coming out of the fridge. By the time I get home (10 hours) its barely starting to feel a bit warmer than at its coldest point.

Just pay attention to the instruction to let the cooler sit out for 10 minutes before putting your pen in it when you are getting ready to go. (Comment this)

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4 - I thought I'd come here to talk about my 8 day trip. I had a big problem with my Byetta pen during the trip. I suspect a combination of altitude change and a too-cold refrigerator in the hotel. Note to self: take thermometer next time.

I flew last Friday from Tucson (3000 feet) to Boston (0 feet). Got a fridge in the room, though the hotel charged me an extra $10 for it. It was very cold, though not freezing. On Sunday morning, when I took the pen out and attached the needle, a weird thing happened: As soon as I pulled off the inner cap from the needle, the entire Byetta chamber turned milky white. I just stared at it, and as I watched, it turned clear again.

I gave myself the injection, but an hour after breakfast I knew it had had no effect -- my bg was up over 200.

So I called the hotline number, and reported the problem. The guy on the phone was very nice, but had never heard of such a thing. He wondered if it was a case of condensation in the space between the plastic outer wall, and the glass wall of the drug chamber. I hadn't known that the pen had a double clear wall, so that was interesting. But it was clear that the Byetta was no longer working.

He gave me a voucher authorization for a new pen. I (fortunately) have my prescriptions filled at Walgreens, and so was able to call a local Boston pharmacy to see about getting a new pen that day. They would have done it, but there were no Byetta pens in Boston -- I called six different Walgreens, and no luck. They could get it by Monday afternoon, but on Monday I was heading for New York.

I called the Walgreens nearest my office in New York, and arranged to have the replacement pen there on Monday evening. They also did not have one in stock, but did get it by Monday afternoon. So I was able to pick it up when I got into town.

So for Sunday and Monday, I reverted to my old oral med regimen, and was glad that I'd forgotten to take my old emergency drug supply out of my purse. I will make a point of carrying such an emergency supply in the future.

Thanks to the pharmaceutical for being so helpful. I had no problems in New York with the new pen, and so far, coming home to Tucson, it's fine.


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5 - BETH IN AZ Re: BYETTA TRAVEL EXPERIENCE:
Wow Beth, what an interesting and unnerving experience you had! Do you personally think it was condensation that took place or something else? I wouldn't think that would have caused the medication to be ineffective though, do you? What is your theory of what happened that made it turn milky white. That is fascinating. I'm glad you weren't off it for too long and NY got you taken care of, and glad you had some oral meds with you. You learned some valuable lessons from this and thanks for sharing so we can benefit from it too. Weird about Boston though. No Byetta in Boston? Unreal. Also, they are supposed to provide a refridgerator for you at no charge I thought. Glad you are back in the beautiful land of Az where hopefully your spit will stay nice and clear! (Comment this)

6 - I personally think that somehow a combination of temperature and pressure changes caused air to be sucked into the drug chamber that morning, when I opened up the needle. I don't know why that would cause the stuff to turn milky, but something did.

It was weird.
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7 - Has anyone take the Travel Pack from Byetta and used some flexible ice blankets that can be cut and inserted in with the packs from Byetta and gotten a longer cool time then with the packs that come with the Byetta Travel Bag?? (Comment this)

8 - I tested it out, and found that the thermometer I put in the case measured sub-freezing temperatures. The problem, I think, is that there isn't enough insulation between the ice and the byetta pen.

It's a great-looking bag. But it's no good for more than a couple hours. The Medicool pack is much safer.
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9 - MEDICOOL, TRAVEL PACK AND THERMOS
I have tested and used all three methods.We travel from Northern to Southern California fairly often both by car and by plane.
First of all, insulin coolers will not work because they are not designed to keep the pen cool enough. We need between 36 and 46 degrees. A refrigerator thermometer has a reference mark at 40 degrees and that is what those of us who have tested the various rigs have used.
The free Byetta travel pack is only good for about two hours, maybe a little more if it is kept cool in the car. It is good for taking the pen to and from work if you have a refrigerator at work or to a hotel within two hours of home. Hotels are required to provide diabetics with refrigerators. Also good to take the pen with you to eat out so that you can be sure you inject within the hour before you eat.
Before the Medicool company decided to make the blue FREEZABLE insert for Byetta use, a man on the monthly blog told us to try a thermos partly full of ice cubes. He put his pen inside one of the plastic cylinders a cigar comes in then put it in with the ice cubes. Those of us who didn't want to buy cigars tested with a refrigerator thermometer in a baggie down on top of the ice and it worked. The trick is to never let the pen freeze. We put it into the thermos with the blue covered part up and the other half sort of into the ice. This lasts TEN to TWELVE hours, and you could replenish the ice at any fast food place or mini-mart or airport if you had to. Others have had NO trouble taking the thermos through security at airports. Be sure you buy or use a tall enough thermos to accomodate the pen and ice, but not so tall that you can't reach the baggie with the pen once it is inside.
I bought the medicool cooler as soon as it was available and it was $55 with shipping. It is good for about eight hours because you freeze the blue insert for at least 8 hours, then let it stand out for 10 minutes before putting the Byetta pen in it. It is in a fanny pack shape, but too bulky to actually use as a fanny pack because of the hard styrofoam insulation. It fits in the tote I use as a "purse" when flying, and has little pockets with room for some needles and for the log book I use to keep track of when I take my shot & meds. You need to re-freeze the insert for the trip home, and use a refrigerator for the pen at your destination.
For long trips by car, the thermos method is probably most convenient and hassle-free, just keep replacing the ice as you go along.
Also take along a thermometer to make sure the refrigerators are at around 40 degrees.

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10 - TONI IN CA- Your comments are very helpful to me. I too bought the MEDI-COOL fanny pack thinI was afraid to freeze the pen insert part but will now do so. It seems strange to me that if I leave the frozen insert out for 10 min, it will not hurt the spit pen. Oh well, time will tell the next time I have to take a long trip which I do not think will be before June. Godspeed. (Comment this)

11 - I expect to begin Byetta within a month or so (pending result of next A1C). We are going to France in May. Has anyone managed this med overseas? Maybe I should just stay on my oral meds until we return (3-4 week trip). (Comment this)

12 - Sally, I think the thermos system would work fine in France. They have ice there. :) Also, I expect that most hotels will be able to give you a refrigerator. Just be sure to check that it's not too cold!
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13 - ***NEW REFRIGERATOR FOR TRAVELLING
If any of you have the store Home Goods where you live, I was so happy to see a small approx 18"x18" refrigerator for only $49.00. It had an adaptor that looks like it would fit into a car cigarette lighter. I think this could be a great thing for us. And to think that it is only 5 bucks more than the medicool bag! (Comment this)

14 - I was interested in Beth's comments about change in altitude effecting her pen. I live at 4500 feet. I drove for two hours to aspen, 9000 feet at the lodge, 14000 feet at the top. I also put the pen in the hotel room frig which did not freeze a pop can but got it quite cold even though we tried to regulate the frig. The byetta did not work as it had at 4500 feet.
The first morning I had a 170 reading. We had a high carb breakfast which I normally do when skiing at altitude. I did not ski hard since my wife got hurt and we quit
early. My noon reading was also 185. I took a second 5mg dose at noon and got a low reading of 67 at five pm so I believe the medicine was still good.
After that I took my normal 5mg shot before breakfast and dinner. The second day we did not ski because we were snowed in and I had readings in the 180s. the third day I only ate eggs and bacon for breakfast and skied hard for three hours. My reading at 11:30 was 220. I had readings in the 180 in the evening and the next morning. I drove back home and at the lower altitude my noon reading was 90.
On returning home I used a new pen and the readings have returned to 130-140 during the day that I experienced before my trip.
So I noticed a loss of effictiveness of the drug in the altitude change and refrigerator change even after substantial exercise. I wasn't surprised that my evening readings were in the 180 range because the cuisine in aspen is spectacular and we were on vacation so we indulgded ourselves a little. Lobster bisque, lobster ravioli and couquille st jacques is mostly protein, right?. One conclusion is that travel and change are hard to regulate and are something you have to learn how to handle. Jessbee in western colorado. (Comment this)

15 - Donna, does that small travel refrigerator maintain a constant temperature that you can set, or does it cool like the other car 'fridges, to "40 degrees below ambient temperature"?

Jessbee, that's very interesting! I expect that altitude changes do make a difference in how our bodies handle blood glucose -- the need to increase oxygen transport might cause our helpful livers to dump more into the blood stream. But now we have two data-points on altitude possibly affecting Byetta. I'd sure like to see more on that. I expect we will. It's a mobile society, and as more people are on the drug, there will be more people traveling.
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16 - BETH, To be honest with you, the booklet with all the instructions was in a sealed plastic sleeve so I did not read all the details. I will try to find out more and report back to everyone who is interested OR if you have a Home GOods in your area, you can check it out. It is a mint green color and nice and portable for car travel. (Comment this)

17 - I think I posted this in the wrong place, so I will re-post in the Travel blog:

RE: Option to buying a Medicool bag - I travel 1+ hour to and from work, and also travel several hours between family locations on a regular basis. I tried the free travel pack that comes with the original Byetta order and found that the gel packs supplied did a really poor job - less than 2 hours of cooling. Instead of spending $44+ for a Medicool bag, I went to WalMart and bought a container of "Cubies" - which are miniature "blue ice" ice cubes (about 1"x1"x1/4"). I then put 6-8 cubies in a ziplock, wrap it in a layer of standard bubblewrap (also bought at WalMart) and put it into the larger side of the byetta travel pack. I also added a little insulation in the form of a couple of layers of standard bubblewrap on the "thin" side of the travel pack. With the use of a small remote sensor that records temperature, I measured that this will keep a byetta pen between 38-46 degrees for about 8+ hours at room temp, and for about 5-6 hours in the outdoors. I then just drop the travel pack into a standard backpack or waist-pack. This is cheaper, easier to load, and since the container of "cubies" (costs about $3) has about 30 individual cubes, I just carry extra cubies in a big cooler and refresh my travel pack when necessary. I have also tested for extended travel (airlines, etc.), for 16-18 hours using cubies, bubblewrap and a stainless steel thermos. I just roll the byetta pen in a 4-6 layers of bubblewrap (about 18" long) and then drop a ziplock with four (4) cubies into the thermos with the pen. Using the remote sensors, test results show that this keeps the pen between 38-44 degrees for 16-18+ hours. This method has kept my pen cool for cross-country travel on airlines and for all-day vehicle travel. I did like the recommendation to take a refrigerator thermometer with you when you travel to make sure hotel fridges are not going to freeze the pen - great idea! Thanks, (Comment this)

18 - Mark, I never thought of using bubble wrap to insulate the pen from the blue ice! Great idea. That adds another option for cooling the spit for a reasonable amount of time.
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19 - I can confirm the bubblewrap works - before I actually used either setup I described above, I tested the temp control extensively (more than 3 dozen tests) using computerized miniature remote temperature sensors (sometimes it helps to have a spouse who teaches science classes). Each of the setups described above were tested at least 3 or 4 times to assure that temps held between 36-46 for the durations shown. You can use any bubblewrap, but I chose the buy a $2 roll at WalMart - it is the type with small bubbles and it rolls and folds very cleanly.

I travel with my byetta pen now and do not worry about either freezing the pen nor it getting too warm. I chose to use the "Cubies" ice-cube sized freezer packs so I would not have to worry about potentially getting the pen wet and having any contamination issues. My only problem has been when I travel is that some hotels provide refrigerators, but they do not have freezer compartments for me to re-freeze the cubies for my return trips. When this happens, I simply substitute an equal amount of ice (double ziplock bags) for the cubies and drop a couple of hours from my expected protected time.

I do not agree with what someone recommended about filling a thermos with ice or packing the pen in a cooler with ice. My testing shows that both of those scenarios can easily result in a frozen pen, with temps well below 32 degrees! (Comment this)

20 - MARK IN MISSOURI= Sounds like a great plan. Tell me something, where did you get your remote sensors? I need something to monitor the temps. Thanks in advance. (Comment this)

21 - I borrowed my remote temp sensors from my wife - she teaches chemistry and science. They are from Onset Computer Corp. and are called HOBOs (e.g. they can ride along with whatever). I used the HOBO Pendant Data Logger (model UA-001) that records temp and set it to record the temp every 5 minutes while enclosed in either the Travel Pack or the thermos. I would just leave the temp-logger in the Pack/Thermos for up to 24 hours and then check the computer readout the following night. Note - the data loggers worked great for testing, but would be impractical to use while traveling since you have to hook them up to a laptop PC to read the temp results.

I am going to try a couple of regular refrigerator thermometers for every-day use. A dial-type thermometer (CDN model PA80) stuck in the end of the bubble-wrap roll inside the thermos (visible by looking into the open end of the thermos), and a small stick-type thermometer (CDN model FG80) in the Travel Pack. I hope these will work as ongoing tools - this would allow the ability to check the temp anytime I want while I was traveling, and I can use the same thermometer to check a hotel room refrigerator as well.

Hope this helps - I will let you know how the regular thermometers work in a few weeks. (Comment this)

22 - I have used a thermos, but I don't just fill it with ice and dump the pen in. I put 3 or 4 cubes in a snack size baggie and put the pen in baggies too. I put the ice in first and then the pen vial end away from the ice. I usually put a refrigerator thermometer inbetween the two and have checked pretty often. I've never seen it out of range, unlike in the refrigerator here at work or even in my house. It's warmer now since overcooling a pen. That was a spendy error on my part. Pat in Idaho (Comment this)

23 - By the way - if anyone was interested, I used the "Thermos" brand vacuum bottle - bought it at WalMart for less than $15 - it is totally stainless steel (no glass liner), is tall enough to take the pen rolled up in the bubblewrap with room to spare, has a very wide mouth so it is easy to get the pen in and out, and even comes with a built-in handle and detachable shoulder carrying strap. So basically I got the entire kit to travel for 18+ hours for less than $20 (thermos, resuable cubie "ice-cubes" and bubblewrap)- and between the all-stainless thermos and the bubblewrap, it basically makes an unbreakable/padded carrier for the pen. It has worked very well! (Comment this)

24 - This problem of keeping insulin and symlin or byetta cool on long trips seems almost insoluble. I am a T1 recently converted from a T2 of 12 years. I've just returned from six weeks traveling from New York to Paris-Mumbai-Bangkok-Saigon-Beijing-Taipei-Kyoto-Tokyo-SanFrancisco and home again (on American Airlines' great around-the-world ticket). So the climates ran from tropical to just very cold, and most of the luggage was stored in cargo bays at 30,000 feet and then was taken through very hot or very cold streets to the mini-bars of the hotels. I had two pieces of luggage beside my carry-on, and I kept insulin and other medications in all of them in case something was lost on the way. The variations in tempurature clearly went far out of bounds, and no doubt the meds lost some potency in the process.

Does anyone on this board know of some available sources that can quantify this loss for me? I would not expect to find anything that would cover the full range of probable cases, but the truth is I have not even been able to find a calculation of the relative strength of two bottles when one has been kept opened for a month under ideal conditions and the other kept similarly at a temperature of 90 degrees. ANY comments would be welcome. (Comment this)

25 - Victor,

I have not flown internationally since starting on Byetta, but I have traveled several times across the U.S. on business trips. Basically my Byetta is a carry-on item only, never checked in baggage. This way it is only exposed to "room" temps. With the use of a thermos I have had no problems keeping the pen in the right temp range for any length flight and travel to a hotel. I store the thermos in the same bag as my other medical equipment (a Bi-PAP machine) and always carry the bag myself. For long trips can you carry both open and "next" bottles/pens with you through international airport customs & security (e.g. in a carry-on bag)? (Comment this)

26 - Now there's an idea, Mark. Thanks. I'll do that. But I am still left with the question: if you are off on a really long trip, are the insulin and symlin/byetta placed as backups in your cargo luggage going to be of ANY value during the trip? Or is there a sufficient difference among the types of insulin that it is worthwhile stocking a more stable form, say insulin R -- although I have no information that suggests that it is more stable than other forms -- as your emergency backup? (Comment this)

27 - Mark, I use a smaller thermos for travel, the "briefcase bottle". It's also double-walled steel, but is very narrow. Just enough room in the mouth to get a byetta pen out. I put a couple ice cubes in the bottom, then insert the pen in a ziplock bag, rolled up and with the drug chamber away from the ice cubes. Seal it up. When I first checked this set up, with a thermometer, I got 40 hours below 46 degrees. I don't trust it that long, though, with the real thing. The briefcase bottle fits really easily into carry-on luggage. You couldn't carry more than one pen in it, though.

The virtue of using real ice cubes is that they are easily replaceable to extend the safe storage period.

For day trips, I use the Medicool bag, but it's not good for long-distance travel since you have to refreeze the insert after 10-12 hours. If you can't be sure of having a freezer, it's not going to work.

If I had one wish for Byetta, it would not be the extended release version. It would be for them to figure out how to stabilize it for room-temperature storage.
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28 - Beth - I would also vote for that! (Comment this)

29 - Beth - I have found times where I have to use real ice cubes also (hotel room fridge does not have a freezer compartment), but when I can I prefer to use the "cubies" since there is no actual melting and thus no chance of leakage, and less to mess with.

I looked at the briefcase thermos and was not sure how well it would keep proper temp, it is so thin I thought it might freeze the pen. I may have to re-think my choice - a small thin thermos would be much easier to carry in a briefcase during the day when I am away from the hotel. Thanks for the information. (Comment this)

30 - MEDICOOL PACK, cont.
The box my pack came in shows the Medicooler for insulin on the cover, with the white cold pack, but on the corner of the box where it says "with insulin cooler compartment", they have put a little sticker over it that says "SPECIAL BLUE COOLER SEE INSTRUCTIONS". At the bottom of that side of the box in a red strip, it says "keeps insulin cool for up to 12 hours", but at the top right of that side of the box is another sticker that says Medicool, then Medicooler, then in a blue strip "keeps
medications cool for up to 8 hours". Below that it
says "contains special blue cooler requires freezing-
instructions enclosed". It does not freeze the pen, but
keeps it at about 40 degrees for seven hours that I know
of, because thats how long it takes us to get to So. Calif. from our place. You can buy an extra blue freezable
pack from the Medicool people for $16.95. I got my kit when it was advertized on the Diabetes Monitor home page back in October. At the Medicooler home page you had to
look below the insulin pack for small print to get to the
page with the Byetta cooler. It was not even in the
catalog that came with the kit. The bill says "MEDICOOLER BLU W/1 BLUE COOLER PA for Medications at 36-46 F(2-8 C) $44.95". I got it back in November, and they may have gotten new boxes that show the blue cooler pack by now.
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31 - Just a thought... Last year, my son had oral surgery, and the dentist suggested a "slush bag" (1/3 isopropyl alcohol to 2/3 water). Does anyone know whether this would make a suitable cooling concept in conjunction with a stainless steel thermos or would it get too cool? I've been experimenting with my steel thermos. I can get the thermometer in the proper range when the bulb is IN the ice; however, when the bulb is at the top of the thermos, the temp is higher than the suitable temp range. (Comment this)

32 - Sara, When I was testing the temp holding capability of a thermos, I used a pair of remote temp sensors and always found the sensor at the "top" of the thermos was warmer than the one at the "bottom" of the thermos. This was true regardless if the ice/blue-ice was inserted on the side or on the bottom of the thermos, and was also true whether the thermos was standing upright or laying on its side. This proved out what everyone has indicated that it is best to put the pen into a thermos plunger end down (byetta chamber end "up").

I don't know if a "slush" bag would work - as you said, it might be too cold. However, I would guess that the airlines might have a problem with a container with alcohol that was not permanently sealed. I have used the fake ice "Cubies" when I can, but I think Beth is correct that using regular ice is the simplest way to go - even when you cannot get to a freezer to re-freeze a Medicool blue-ice pack or "Cubies" you can always get some ice from a hotel, a restaurant or even from the airlines. (Comment this)

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34 - i am new to this and would like to know if anyone has tried those portable car coolers that plug inot the car or also work on electricity. Also went you use the thermos onit's side, doesn't the ice melt and there is water/ice by the chamber of byetta?

thanks
charlotte (Comment this)

35 - When I use the thermos, I have the ice in a snack size baggie and the pen too. I have never had the pen get wet yet. Be sure to read the directions on the portable car coolers carefully. Many only cool to 40 degrees less than the air temp which in the summer wouldn't be good most places. Pat in Idaho (Comment this)

36 - Your comments have all been helpful. I recently went on a trip to Hawaii where I was traveling for 16 hours. I had to take 2 Byettas because the one I was using was not going to last the full week that I was going to be gone. I put one pen in a Medi-Cool "insulin protector." and the other in the Byetta cool bag thing that comes with it, and encased both in additional insulating containers. I asked the flight attendant if I could put my medications in their refrigerator, but they said no. Instead they gave me a big ice bag in a garbage bag with another bag to put my medications in. This started to leak by the end of the flight. My meds were borderline coold by the time we arrived in HI. The fridge in the hotel was not really very cold, though I did not bring a refrigerator thermometer along (where do you get those?). We got the hotel to recharge the fridge, which helped. On the way back, it was worse. The attendants would only give me a small bag (the vomit bag from the back of my seat) full of ice. Again -- the temp of the Byetta was "iffy" on the warm side when I got home. The briefcase thermos idea sounds good. Does anyone know if it would fit two Byetta pens if necessary?

BTW -- I always bring backup NPH insulin with me, which does not need to be refrigerated, in case I need to use something other than the Byetta. (Comment this)

37 - I'm not sure if I have the "briefcase" thermos that is often mentioned here or not. It think it is the same one--tall and slender, all steel, no glass liner. I think you would get 2 pens in it, but the ice would probably need to be crushed then. I use a strip of 3 blue freezer cubes. They are rectangular in shape and fit easily into the mouth of the thermos. I also have some artificial ice cubes (not blue) from Walmart that don't fit--they are too square in shape.

The thermos has stayed relatively cool for up to 10 hours with only the 3 blue cubes. The cubes have melted by that time, but it is still cool inside the thermos. (Comment this)

38 - Does anyone know how critical it is that the Byetta pen not get wet? I think the medication chamber is pretty well sealed. I have an outdated 5mg pen (if I can rescue it from the trash compactor before someone crushes it) and I think I will try immersing it in a bowl of water dyed blue with food coloring and see what happens. (Comment this)

39 - My only concern with the pen getting wet would be with the rubber seal having bacteria on it that the end of the needle could carry into the vial part. I assume you could clean the seal itself with a wipe and it would be fine. I sort of doubt that water could get into the med or anything like that. Pat in Idaho (Comment this)

40 - Elaine and Pat:
Let us know how the experiment goes. It sounds like a good way to find out if the chamber is sealed or reseals after each needle punch. (Comment this)

41 - Hi everyone - First of all, thanks from this newbie for all the helpful information shared here. When I started "running with the lizards" a month ago, I had a vacation to Mexico planned (two travel days of 12 hours each, refrig/freezer at destination) so I've really appreciated the "what-works-what-doesn't" info on this blog.

For my cold-carry system, I started with the 25.5-oz. "briefcase bottle" all-stainless thermos (must be the same one many have mentioned). The pen fits inside perfectly. While ice and baggies are a good option, I wanted to find a waterless method. I hadn't seen (still haven't!) the refreezeable ice "cubes," but I made refreezeable ice "tubes" -- I ordered a dozen 1/2" x 6" plastic test tubes, plus flanged caps, from the web (about $5 for all), clipped the corner off a small refreezeable gel pack, filled and capped the tubes, and froze 'em up. Four tubes fit in the thermos along with the pen; they surround it and maintain a good temp but (even without a bubble-wrap sleeve) don't freeze the med. I added a thermometer from the hardware store (the oven-safe kind, long probe with a flat dial on top, so I could check the temp just by opening the thermos). Everything worked great, the thermos was small and light in my carry-on and sailed through customs. When I arrived after 12 hours, the thermometer registered mid-30s, the tubes were still frozen, and the med was happy and cool. Will do time tests one of these days to see how many hours the system will stay at temp.

I didn't try it, but I believe a second pen would fit in the thermos in place of one of the tubes. (Comment this)

42 - Merricat:

Are these glass or plastic test tubes? If glass, I would worry about them breaking -- especially with freezing and thawing.

Plus, I like the idea of using plain ice cubes because they are readily available in airlines and hotels and you can replace them if the Byetta starts to go above the recommended temperature range. Freezers (for refreezing inserts) are not readily available when traveling.

Elaine (Comment this)

43 - I purchased a "briefcase" thermos to try and have been seeing the same problem as Sara. e.g. the bottom of the thermos (in the ice) gets cold enough, but the top of the thermos barely reaches below 46 and stays in the temp range for only a brief period. Additionally, the briefcase thermos I have will only take one pen and 2-3 ice cubes (crescent shaped cubes from an automatic ice maker). Those of you that are having success with the briefcase thermos, please identify the brand and model (if possible). Finally Merricat - will you please identify what website you got the tubes from? Thanks, (Comment this)

44 - Mark, the "briefcase bottle" I used is Thermos Nissan Compact Beverage Bottle model # FBB750, 25.6-oz. (0.75L). Here is the link to this model on the mfr's website (not where I bought it):

http://www.thermos.com/thermos/cfm/prodDetail.cfm?pg=2&id=675&z=z

And the link to the test tubes:

http://www.testtubesonline.com/ProductDetails.asp?ProductCode=LCM+6PSC

I forgot to mention above that I put the thermos in the fridge the night before I traveled. The mfr's instructions tell you for best results to use cold or hot water, as appropriate, to pre-chill or pre-heat the inside of the thermos. I had the time, so just put the whole thing in the fridge instead. (Comment this)

45 - Merricat,

I think part of our different experiences is that Thermos makes 3 Nissan Compact (e.g. Briefcase) stainless bottles; 16 oz (1/2L), 25.6oz (3/4L) and 34oz (1L). You and a couple of other folks have been working with the 26oz size and I (and possibly Beth) have been working with the 16oz size. I found (like Beth) that all I can fit in the small bottle is one pen and very few ice cubes. Even so, it still appears that it may keep the pen chilled as long as the larger Thermos (44oz - 1.3L) that I used for travel during the first 6 weeks I was on the spit.

The large thermos would last 18+ hours using the artificial ice "cubies"; and last night I tested the small briefcase bottle and it stayed in the temp range for 20 hours. Smaller, lighter and stays at the right temp range as long (or longer) using regular ice cubes - sounds like a winner to me!

Thanks for the information, or I might not have even tried the smaller thermos bottle.

Mark (Comment this)

46 - Hi! I'm new to using Byetta. In fact, I just got my first pen last night and took my first doses today. I travel a lot in my job and I'm concerned about traveling with the pen.

I've read the posts about the medicooler with great interest. Has anyone tried the Frio Duo Pen Wallet? They claim it will keep the pen cool up to 45 hours.

Also, how did you all get the Byetta travel pack? I got my prescription filled at Walgreens.

Thanks.

Sammy! (Comment this)

47 - The byetta travel pack can be found at www.byetta.com/welcome, but it is only good for a few hours. Is the Frio Pen Wallet you talk about specifically for byetta. Many products available are only suitable for insulin which has a much less restrictive temperature variation. Many of us use a steel thermos with a few ice cubes for travel. You can get more ice most anytime and anywhere. If you read through some of the posts you can find more detail. Pat in Idaho (Comment this)

48 - Mark -

A big "oops" from me - could have sworn I got the middle size of those three thermoses, but I just checked again and it turns out I have the smallest (16 oz., FBB500), like you. Thanks so much for testing the temp timings. It's great to know it will keep in range for twenty hours. That's pretty darn satisfactory.

I just checked my bottle and found it will easily take two pens plus three "ice tubes" (just slide them in one at a time). I'm pleased to know that regular ice will also give good results. Glad your new system is working for you, too! (Comment this)

49 - Merricat,

Due to the cost & issues of "killing" a pen, I am running a series of tests to check temp & duration. Yesterday the small Thermos stayed at temp for 22+ hours with 3 ice cubes - probably lasted a bit longer since the bottle was somewhat pre-chilled due to the prior test. In either case - it still works great! I am running a test with 4 cubes today, want to see if it will keep over 24 hrs! I also think you are right - you could get 2 pens in, but it would definitely be a squeeze if you are using regular ice cubes! Crushed ice would be better! Regardless - thanks again for the info, traveling with the small thermos vs. the big one I have been using will be a great improvement (less weight, less space, longer cold times, etc.)! Your advice is appreciated!

Sammy - Several people have written in this and other forums that the Frio pen should NOT be used for Byetta pens. The Frio pen is designed to work for insulin, and claims to keep it below 70-degrees for 45 hours. Your new Byetta pen needs to be stored between 36 and 46 degrees - see the patient information sheet that comes with the prescription for more information.

Most people have found that the Travel Pack will not keep the pen cool for more than 1-2 hours. Some folks have reported success substituting the small flexible "blue-ice" packs or the "Cubies" artificial ice cubes in place of the gel packs. Just be careful not to freeze the pen or you will "kill" it!

I travel in my job also - and I have had no problems traveling anywhere in the U.S. using an all-stainless steel thermos using the fake ice cubies. I have also been testing the small briefcase type thermos using regular ice with excellent results. Next trip is in a week - I will let you know how the it works. (Comment this)

50 - Mark:

Just got my 16oz thermos, but haven't gotten an appropriate thermometer to check it yet. Are you also using the bubble wrap around the pen??

I found my expired 5 ug pen -- haven't gotten around to doing the "blue water test" yet -- maybe this weekend. (Comment this)