The Duodopa Gel has to be kept refrigerated. A month’s supply of cassettes – 4 boxes of 7 cassettes per box - will take up an entire shelf of a normal sized domestic refrigerator.
A good small bar refrigerator is an option as is a medical grade vaccine refrigerator as used in pharmacies.
However it is done, keeping the medication between 2 and 8 deg C is essential.
The Pump is not waterproof and has to be removed for showering or bathing.
The Pump batteries need to be changed every week.
The PEG-J tubing and Stoma site
The two tubes have to be flushed with clean water every night. This is done with a 20 ml syringe.
Care needs to be taken in securing the tubing between the Stoma and the Pump. This protects the tube from being caught and dislodged or damaged. There are several securement devices available from medical supply companies.
There is daily care and cleaning required at the insertion site and the tube to reduce any chance of infection
The Duodopa cassettes are for single use only and should not be administered for longer than 16 hours even if some medicinal product remains. This timing can be varied downwards – depending on user needs.
Using the Pump does involve the same sort of timing discipline as oral medications. The pump on and off times should be fixed i.e. on at xx:00 am and off at yy:00pm every day.
The pump, and the associated medication, adds a whole new level of complexity to travel.
Many Pump users travel using portable refrigerators in their car or cool boxes on a plane supplemented by hotel refrigeration. AbbVie supplies a travel cool box that will maintain the correct temperature for 14 cassettes for 36 hours.
International travel is also possible with careful planning.
The only other requirement when travelling is clean water for the tube flushing and as drinking water is suitable for this task, flushing should not be an issue.
Oral Levodopa medication should also be part of the travel kit as a backup.
AbbVie supply a range of wearable pump cases. They are effective but noticeable.
The alternative is to source other clothing items that either replace the AbbVie product or disguise it.
The key consideration is to keep the pump secure and prevent it from falling and causing damage to the PEG-J tubing.
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