Have Medicine Will Travel

Part Three: Preparing Medicine for Travel

“Are you a drug dealer?”  That is how a US Customs inspector greeted me as I was trying to enter the United States through the Miami airport a few years ago.

I was in the “nothing to declare” line when, after examining my passport and declaration card, the agent sent me to another inspection station where an older inspector greeted me.

“Please open your suitcase and remove your backpack for inspection,” he requested.  He was polite but firm.

I proceeded to do as he asked, first removing my backpack and unzipping all the pockets and then unlocking my suitcase and opening it.  As soon as I opened my suitcase I saw a notification that Customs had already opened my bag.

“Well,” I thought, “that explains why I had to wait forever for my suitcase.”

The customs inspector took everything out of my suitcase and placed it on the table.  Since I pack my clothes and gear in zippered bags, he had to unzip each bag and pull out the contents. He even turned all my socks inside out (more on that later.)  Then he came to what he evidently had been told to look for—my zippered bag of medicine.

“Are you a drug dealer?” he asked, as he spread out dozens of small plastic bags on the table in front of us.  Each little bag contained over twenty pills consisting of one days’ worth of my Parkinson’s medicine and supplements.  I was heading home after a two-week trip and, as was my custom, I carried at least twice as much medicine as I needed, with half packed in my carryon and half in my checked luggage.   I carry enough extra medicine to get me through trip delays or lost luggage.

“No, I am not a drug dealer!” I exclaimed, “I have Parkinson’s Disease and must take medicine at regular intervals throughout the day if I wish to function.”

“Why do you pack your medicine in the plastic bags?  Why not leave them in the bottles?  May I please see your prescriptions?”

“I pack my pills in these little plastic bags, so I can have one day’s worth in my pocket during the day.  If I carried the bottles with me when I traveled I would have no room in my suitcase for clothes, and, furthermore, I certainly could not carry the bottles to client meetings.”

“Okay, I got it,” he retorted.  “Please let me see your prescriptions for each one of these pills.”

“I’m sorry,” I replied.  “Only a few of the pills are prescription, and the rest are supplements. I do not carry copies of the prescriptions around with me; in fact, the prescriptions go straight to the pharmacy, and I do not even get a copy.”

“All right,” he said, “I’ll accept your story.  But, please count the money in this sock.”

Here I must explain that I occasionally stash small amounts of cash in my checked luggage on the outside chance that I will need it.  I typically stash a few hundred dollars in small bills, enough to get a taxi from most airports to the city.

When the customs inspector saw the cash stuffed in one of my socks I could see from his face he was eagerly expecting I was carrying a lot of cash, and perhaps I was, compared to most travelers.  However, what really alarmed him, aside from the little plastic bags of medicine, was that I had cash from several different countries in my carryon.   Because I frequently visited several countries every year I made it a practice to carry enough local currency to cover a couple days’ expenses just in case I should lose my credit cards.

“How much cash are you carrying if converted to US dollars?” he asked.

“I have no idea,” I said.  “But I am sure much less than $10,000,” I replied.

After a few more back-and-forth comments, he let me repack my suitcase and proceed on my trip.  I was calm throughout the whole procedure, knowing that I had broken no laws.  Then, just as I was about to leave, he remarked:

“Mister McCain, you should take up poker.  You have the most flat, deadpan face I have ever encountered.”

“I assume that is a compliment,” I replied.

He smiled.  He was just doing his job.

I tried to smile.

As I exited the airport, I chuckled to myself.   I could not tell him my blank face was really part of my Parkinson’s disease and many PD patients develop the Parkinson’s “mask.”  There is no pill for the problem; no matter how hard I try, it is very difficult for me to smile.

Besides, I gave up poker in college and took up blackjack.

 

This blog post, Have Medicine, Will Travel, is the last of three parts.

Part Two discusses the problems, and provide solutions to, traveling within and across time zones and how to adjust your medication regimen to accommodate time zone changes and your travel schedule.  That blog post is here.

Part Three, Preparing Medicine for Travel, is the subject of this blog post.  It may seem curious that this post comes after the discussion on managing your drug schedule since you must prepare the medicine before you travel. However, discovering the complexity of maintaining a rigorous medication schedule while traveling illuminates the importance of preparation.

 

Preparing to Travel

Before embarking on a trip, I prepare my medicines. I place the pills for daytime and nighttime doses in small cups (Exhibit 1). Once I have distributed the pills into cups, I package each day’s meds into two 3” by 3” plastic bags (Exhibit 2): daytime meds (17 pills) and bedtime-morning, or “nightstand” meds (6 pills).  Next, I put ten bags of daytime meds and ten bags of “nightstand” meds in plastic baggies (Exhibit 3); I put these two into a still larger plastic bag, so it now holds a ten-day supply of medication, divided into daily doses and separated by time of day I must take them.  If I expect to travel for a weekend, I take one of the larger baggies containing enough medicine for one week.  If I plan to be traveling for a week, I take enough medicine for two to four weeks, especially if I will be out of the country. I take extra medicine in case my return is delayed.  I split my medicine into three packages:  I keep a small envelope of Sinemet on my person.  Then I stow a much larger amount of all my daily meds in my backpack and another large amount in my checked luggage.  I carry Sinemet with me because without it, I cannot safely move. The duplication between my backpack and suitcase is insurance against one or the other piece of baggage being delayed or lost in transit.

My hotel nightstand holds a bottle of water and my nighttime and morning—or “nightstand”—meds. I keep them within reach because many times my balance is off late at night.  I must take my morning meds about 90 minutes before I wish to leave the hotel and I try to minimize my movement for at least the first 30 to 45 minutes following my first morning dose. Sticking to this routine is easier if everything I need is at my fingertips.

Summary

Going through international airport customs with many different types of medicine is much less of a problem today.  Since the incident I described in this post, I have only been questioned once.  A letter from a PD doctor saying you are her patient and your disease may manifest as signs of tremor, soft voice and uneven gait should answer most questions.  A statement that you may be carrying a substantial quantity of various medications and supplements is sufficient.  Still, while I do not carry copies of prescriptions, I do carry a large bottle, from the pharmacy, of carbidopa-levodopa (Sinemet) that contains enough pills to last me three months should I be stuck somewhere without access to a pharmacy or a doctor that can prescribe Sinemet.

Prepackaging medicine for vacation or a business trip is not a problem for most people, but when it is, my solution is superior.  Travel catalogs offer various pill containers with pouches or boxes with markings for the day of the week.  I tried all these options, but they do not hold enough pills, wear out, are poorly made, and are expensive. For the price of a few paper cups and plastic self-closing bags, you can create a system that is perfectly suited to your specific needs.

 

                Exhibit I                                     Exhibit II                                    Exhibit III