Long-term Travel

Hi Everyone! I am wanting to teach abroad for a year but I am concerned about bringing all of my pump supplies/ medications with me. Does anyone have any advice or experience on spending a year or more in a foreign country? Has anyone tried to receive pump supplies from the international Medtronic sites while traveling?
Any and all information would be helpful.

Thank you!

@norrish

It’s great that you’re going to teach abroad. I did live in Europe in the early 90s and had no problem getting medication needles and insulin. Plus it’s all free.

How fun! I haven’t traveled for that long, but when I was in the UK for a few weeks, Minimed told me they could “rent” me a backup pump in case mine pooped out. I took twice as many supplies as a thought I’d need, and came out more than fine. I would think your current insurance would still be covering you, as opposed to anything from an NHS. Minimed should be able to give you some advice, especially now that they are in so many countries.

if you don’t mind a stupid question… how foreign of a country are you going? In my opinion, Europe is mostly okay, but spots in South America, India, Africa, and China scare the heck out of me. I once threatened to resign over an assignment that would have put me in an industrial area of India. The reason was that a T1d with raging dysentery in an area with no hospitals for 100 miles could easily die.

along with the fine advice above, go over the latest TSA regulations, make sure you have a copy of your passport (the page with the number and picture) with someone, see if you need to check in with any embassy, get yourself an international SOS card with all your emergency numbers in one place, make sure you have a buddy either with you or a sponsor who will expect your arrival and be able to call someone in case you actually don’t and use the heck out of google to find hospitals and other fallback facilities… just in case.

cheers and good luck!

Hey everyone.

Thank you for the all the advice and feedback.
Not a stupid question at all Joe. The program I had been accepted to was in China. I use the past tense because today they called to inform me that they would have to revoke the acceptance until if/when they could find out if it would be plausible for me to go over there while being a Type 1 Diabetic.
I have been talking to my doctor and was told the most she could prescribe me was for three months of medical supplies and that I would have to find an Endocrinologist in China in order to fulfill my prescriptions. International Medtronic representatives simply say they do carry supplies to buy, but have no idea how this would work including shipping and prescriptions.
So at this point I feel defeated. I hate the fact that because of this disease I have such limitations on what I can do with my life. I have been trying for figure how I could travel overseas for an extended amount of time for years now. I love teaching English and traveling. It’s just sad to realize this may not happen.

@norrish

GO GO GO take shots!!! You will feel much stronger!!

Hi! I just want to say, do not give up! I completely understand how it feels having T1 limit your dreams, but i promise if you do not give up and you keeptrying, youll be teaching english abroad in no time. I have been fighting to get medically cleared to serve in the Peace Corps for over a year now, and after many invitations, which were then taken away from me due to my T1 diabetes, i juat felt defeated. This has been my dream for a while now. I kept trying and i juat recently received grgreat news about a project in thailand ! It works out, as long as you dont give up. Keepfighting for your dreams!

All my best!

Our daughter took many vials of insulin in a xtra large Frio pack, a carry own with 3 months supplies of infusion sets and cartridges, and we sent her infusion sets as she got her next 3 month supply. That’s all assuming that the mail is reliable in China. With the Frio, as long as you keep it moist, it will keep the insulin cool until you can refrigerate. The insulin MUST be cold when you place it in the Frio. Hope the organization reconsiders!

I’m sorry you’re hitting roadblocks. It is possible to travel long term, though, so don’t give up! I spent my junior year of college in Switzerland. I probably could have seen an endocrinologist there and gotten levemir (instead of lantus, which I usually take), but I was nervous about navigating doctors’ offices and pharmacies in a foreign language. So instead I brought a 6 month supply with me when I first moved there and then my family sent me another 6 month supply later in the year. I also visited home in December so I could see my own doctor. I can’t remember how exactly we got the full 6 month supply of meds. I get a little more than I actually need each month, so it’s possible we just had some stockpiled. It’s also possible my parents paid for a couple months of insulin out of pocket. I could find out if you’re curious. In any case, I got through the whole year without ever needing to see a swiss doctor or visit a swiss pharmacy. I’ve also spent a week in Costa Rica and a week in the Dominican Republic. Same principle, just shorter time frame. Each trip I brought about double what I thought I would need with me (for “just in case” type situations, like a bottle breaking). The tough part in those two countries was refrigeration. I second Obtainedmist; Frio packs are a huge help! I also had a Medjet membership, so if I got sick I could count on transportation back to a US hospital.

Norris, you can definitely do it, and props to you for wanting to!
I spent a semester in England, the majority of a year in New Zealand, 5+ months backpacking in Asia, 5 weeks in Haiti after the earthquake (and a few subsequent, shorter ones) and many smaller trips all over the place. It takes a LOT of work and planning, but it is 100% doable.

For one thing, definitely get a loaner pump, and talk to them about international replacements. (or, as someone suggested, go back on shots. I’ve been on pumps for 18 years, but I definitely considered it at one point because it is a LOT less gear than life with a pump!). Try to stock up on as many supplies ahead of time, and depending on your living situation, to either bring it with you, or arrange (conservatively-timed) care packages. I was fortunate in NZ that I had friends there already, and shipped a few months worth of supplies to a few different people in the county, and I had visitors bring insulin with them halfway through, although truthfully I could have carried enough of that. At the time (10 years ago or so) the supplier were unwilling to send them to me in other countries, even though they had locations (or subsidiaries, or whatever) there, because they’re technically different entities, so my only choices were to either carry with me or have people at home ship them. Once you’re settled in China, you’ll have an address that your friends and/or family can ship to, just be sure to use a reliable international shipper like FedEx or DHL (again, hard supplies, not meds or insulin). I did run into trouble trying to replace a broken pump several times; New Zealand wanted to hit me with an exorbitant tax on medical supplies, and I can’t remember how I got around it. Again, talk to representatives at all of your companies before you go. And there are some good Diabetes Educators who can help you with this, because they’ve seen other clients through it.

You MUST have good health and travel insurance before you go, because there is of course an increased chance that you’ll need help and/or to come home. It also helps to sign up with a service that can connect you to a doctor that speaks english in an emergency (there are several companies that do this), AND to identify a doctor (ideally an endocrinologist) before you go that you could potentially meet with upon arrival and further help connect you to resources on the ground. Be aware, too, that there is phenomenal medical care in both Singapore and Hong Kong, and it might be worth going to one of those locations 6 months in to meet with a specialist, if there isn’t anyone near where you’ll be located. But it might also be worth it to come home midway thought–to see your doc, to refresh your supplies, and for the mental break. If you’ve never been away for a long time–or even if you have–it’s nice to take a break if you have the time and money.

I don’t know if you were trying to go through a particular program or to a certain location, but I know that a lot of programs are often more comfortable putting us in cities than rural areas. And while that may not always be the extensive adventure that many of us are seeking, my advice to you is that if it is the only way for you to get there–do it! I used England, and then New Zealand, as progressive jumping off points to learn what I was capable of/what I needed. And I’ll admit, it often still feels like I’m making it up each time.

Frio packs and coolers are helpful for keeping insulin cool. So is a bowl of water (if keep insulin in water or on ice, I recommend keeping the vials themselves in a sealed plastic bag, so no bacteria from the water get in), and even a washcloth that was kept in cool water (or frozen the night before–the cloth, not the insulin!) and wrapped around your vial for the day, if traveling. In my experience, heat has not been as detrimental to insulin as I’d been warned about. It definitely affects it, but it does not destroy it. So you do what you can, and adjust your doses as necessary (I’m talking normal, living in a tropical place, heat. Not keeping it on the stove). And yes, bring extra. Unfortunately, for this to work, you will need to bring more stuff with you than your peers.

I’m sorry for the length of my post, but this is something I feel very passionate about, and I’m fairly experienced with. It can be extremely frustrating, and sometimes it feels like everything is against us, and it certainly doesn’t feel fair–but you CAN do this! I don’t come on here much, so I’m not positive how this works, but you’re welcome to contact me directly with more questions if there is a way to do so.

Keep fighting!

Hi Norris - Similar to Stephanie, I think you can totally do this!

It’s just about planning it out.

One tip: If you’re near Hong Kong, you can use the “Poste restante” system to ship a package of supplies to the mail carrier. See more here: Poste restante - Wikipedia

This may not work for insulin, but it could work for your other supplies.

I am currently on a year-long trip through South America, parts of Africa and SE Asia, and am carrying 3 months of supplies at any given time. I am having my family ship me the rest (in 3 month chunks) while on the road. I’m blogging about my experiences and preparation here: www.diabetictraveler.org, and am happy to chat as you figure your trip out.

Best of luck!!

Wow! Thank you to everyone! You have all been very helpful and encouraging. I am working in the US for now- but still applying to teach abroad in the upcoming year. It is seeming more and more doable.
I am actually spending a couple of weeks in Spain this Winter! I am excited and getting prepared for that trip will help me know more of what a long-term stay may look like.
I am now looking at teaching in a Western European country (at least to start with) :wink: I believe it can happen! Thank you for understanding and for being a community to help navigate these issues that can put us in unique and challenging situations. Ya’ll are the best! <3

All the folks who said that you CAN do it are DEFINITELY correct.

CONSTANTLY stock up on supplies. Insulin and test strips- always get the max amount that your insurance company will allow at each month or 90 day interval. If you’re not building up extra supplies fast enough, then you might consider intentionally eating more carbohydrates for a few weeks (and using more test strips by testing) before your next endocrinologist or diabetes educator appointment, so that that provider can then increase your monthly prescription.

If you like to travel, I think you should always try to maintain at least a 6 month surplus of supplies at your home. (This also means organizing your stuff- you certainly don’t want hundreds of dollars worth of meds expiring because you forgot it on a back shelf somewhere.)
**Really though- organize your stuff by expiration date with the oldest in front (I’ve been known to use test strips that were long expired due to me not staying organized… don’t worry- I did several test tests with non-expired strips to make sure performance is on par)

My first year abroad was during college, to Lima, Peru -still on parents insurance- I found an insurance loop hole at the time where they’d give me the usual 90 days max script at a time, and then also a ‘special 90 day travel allowance’ and then I just made sure to order a regular 90 supply about a week before requesting the travel dosage.
-With that 6 month supply, I went to Peru and I made sure that back home my scripts kept getting filled and collected and stored by family members for the next 6 months while I was in Peru.
-At about the 6 month mark, a housemate had family visiting her from our same state- They were willing to bring another 6 months worth of insulin, strips and pump supplies with them as long as my family could drop everything off before they flew out. :slight_smile:

I got an amazingly efficient “disposable” styrofoam cooler and ice packs by just asking my pharmacist- who gave me their used ones from the last medication delivery they had received. It kept insulin cold basically forever.

Second year abroad was also in Peru- my insurance company would not longer provide a “special 90 day travel allowance,” but by that point I’d already started stocking up. I think I took around 6-8 months of supplies with me, and again was able to find someone who would be willing to bring meds with them when they were visiting someone else that I knew.

If you’re a pumper, remember that for a 3-4 week backpacking trip, you don’t need refrigeration/coolers. -That saves tons of space/effort.
Officially, the insulin is good for “28 days without refrigeration” - I find that to be a flexible number- just don’t keep the insulin in the top pocket of a black bag while you hike through the rainforest :wink:

***I actually came here originally to ASK a question though- Anyone have suggestions/experience for making pump supplies (Medtronic Infusion Sets) more compact when traveling?

A one month supply (plus the extra 50-75% worth of back up tubing) takes up WAY TOO MUCH ROOM when living out of a backpack for a month…
I recently ended up opening numerous sterile infusion set packages and repackaging each infusion set in a snack-sized ziplock so that, without the bulky protection, each set would take up less room and then putting most in a plastic “watertight” container from the camping section of a supermarket… It certainly saved space- but I’m wondering what other techniques people have employed for saving space while traveling?

I spent 12 years traveling all over the world in mostly 3rd world countries before there were insulin pumps, CGM’s and even blood checkers in my first 5 years. I live how much easier it is now with traveling, time changes, CGM while traveling today. I have had dysentery, amoebas, you name it and yes survived.
It’s amazing how much you can pack in your suitcase and carry on. With today’s technology there is no reason you can’t travel to China. I reuse or extend my pump supplies so a full 3 months can be stretched a lot farther and you can be very creative in getting things shipped.
Rule number 1 is get a back up pump, blood tester and transmitter.
Rule 2. Always bring syringes in case you have issues with pump and bring prescription for long acting insulin in a pinch if you need to. That also is good backup I you run out of supplies.
Rule 3. Extra glucagon shots and train someone you’re working or living with how to use because yes getting ambulance or hospital may not be available.
Rule 4. Know where local embassy is and doctor is. They have us doctor for personal on staff which you can use as well for medical needs.
Rule 5 bring all your insulin with you. Europe and some counties use different mixes and types of insulin.
Rule 6. DO NOT put insulin in those small fridges with open freezer in door or near top. Always bottom shelf. I froze my insulin once in Uganda and really messed me up.

Feel free to contact me with any questions. I think I’ve wxpweienced every mishap one could have overseas and lived to tell about it.

Also tips on flying always have insulin with you in small container in case they want to take your carry on before boarding plane to put it underneath.

I know this is a very late response however I had the same problem except I actually WENT to China. They told me everything would be fine and when I got there it was not…They had the insulin I take but for the injection pens not for the insulin pump. I had to pay everything out of pocket and could not get any of my pump supplies there. It was a nightmare to say the least. I had to come back when I was down to half a bottle of insulin. So I completely understand this struggle. I am currently feeling held back by this disease in trying to switch jobs and move abroad again. What ended up happening if you dont mind me asking? Would love to connect on this. What company did you work for? This was around the same time I was in China.