Travel and HPN
Do you find articles on Home Parenteral Nutrition (HPN) and travel hard to believe? When you read or hear HPNers recounting their travel experiences are you sure they must be exaggerating or on a very simple, minimal HPN regime? Do the logistics seem impossible and, even if not, the idea of travel causes tremendous anxiety? Did you used to enjoy travelling, but now you`re on HPN feel travel is part of the past? Then this article is for you!
Contrary to what you may think, people who travel whilst using Home Parenteral Nutrition (HPN) are on a range of different regimes, from partial to full HPN.
In my case, I have travelled widely and also been on total HPN for 20 years requiring 3 litres of amino solution plus some saline daily and there are many more HPN travellers like myself.
My first trip, was only one month after my discharge and it involved taking my son for a week to Toronto visiting Wonderland, the CN Tower and Ontario Place. Since then I have travelled throughout Canada, the USA, and Europe. In fact, I have just returned from the Oley conference in Milwaukee and currently I am planning trips to Manitoba, NW Ontario, and possibly Europe this Fall.
Travel Tips for those with HPN
Transporting your Parenteral Nutrition Solutions
You should be well informed about what you need to maintain your Parenteral Nutrition (PN) solutions. Discuss requirements with your supplier, hospital pharmacist, HPN team or doctor.
For transporting your solutions use a picnic-type cooler. On a short trip, a small styrofoam cooler large enough for a few solution bags will do. Eventually, for longer trips, you will need coolers of various types and sizes.
To keep your solutions cool use refreezable gel packs available at any hardware store. Also get a small thermometer for the cooler. The recommended safe range is 5-10 degrees Celsius. After packing the cooler, cover the bags and freezer packs with a heavy towel to keep the cool air inside. Fill empty spaces with lightly crumpled newspaper, adding more as you use the solutions. The paper and the towels will act as insulation and prolong the ice packs.
On The Road
There are various ways for creating a work surface whilst travelling, but as a novice the best approach is a new metal cookie tray which will fit into your suitcase and is swabbed with alcohol prior to use.
For disposal of ancillary items carry opaque kitchen bags or if your solution bags come in an opaque plastic outer bag use it. If it is labeled, turn it inside out to maintain privacy. Don’t dispose of your syringes or needles away from home as nobody will appreciate these items in their landfills. Use zip lock bags for the syringes and a small plastic bottle (pill vials work well) to store needles until you get home and can use your usual ‘Sharps‘ disposal method.
Regardless whether you infuse by gravity or a pump, your IV pole should dismantle for easy transportation unless you use a portable pump. If you use any kind of pump – even portable, pack an extension cord as hotel electrical outlets may not be as conveniently placed as in your home.
If you use a portable pump, carry a small metal coat hook that fit over a door top and a couple of ‘S’ hooks like those used for tie-downs (both available at hardware stores). These are convenient if you hang your solution to prime your tubing using gravity. Such hooks can also be very important if your pump fails and you must use gravity.
Whilst travelling on HPN requires extra planning, flexibility, and a rather large luggage allowance; travel can, once again, become part of life. Before travelling becomes the norm once again, you have to make that first trip and overcome the anxiety and concerns inherent in any new experience. Completing your first trip, however small, will give you the confidence to venture forth again and each trip will increase your comfort levels and your confidence to handle the necessary preparations and deal with the unexpected.
I hope this article will encourage you to make that first trip, re-introduce yourself to travel, and continue to enhance your quality of life on HPN. All that I or other HPN travellers can do is provide information and encouragement. The ultimate decision is yours alone!
Editor’s Note: The above article has been written from my own experiences and deals with travel on parenteral therapy. It is intended as general guide only. For each individual, travelling is an individual experience and should be done only after consultation with your doctor and within the context of your protocol.