Accredo Calms Rough Seas for Cruise Passenger

Aug 28, 2018

As the summer winds down, many of us treasure the memories of vacations and new adventures shared with loved ones. Holly Rosenblatt, regional clinical pharmacist at Accredo’s Pulmonary Arterial Hypertension Therapeutic Resource Center, highlights how she and the Accredo team helped ensure a patient’s vacation ended on a happy note.

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As an Accredo pharmacist, I’ve learned that patients – including those living with complex medical conditions -- are often on the go. It’s my job to help ensure they have access to their medication and know how to take it, wherever they may be.  So when a patient with pulmonary arterial hypertension (PAH), on a Caribbean cruise, broke a bottle of the medication that keeps her alive, my team went to extraordinary lengths to safeguard her health.

Like many of our PAH patients, she carries a small pump that infuses her with medication 24 hours a day. PAH is a disease that causes a constriction of the arteries in the lungs, which, in turn, causes the heart to have to work harder to pump oxygenated blood throughout the body. These patients can't risk running out of their medication; if they do, they need to get to the ER as soon as possible. As you can imagine, patients always have their medicine and pump with them.

This patient's back-up supply of medication had broken. Ordinarily, we could courier a replacement bottle to her to avoid an emergency. However, she would not be in a U.S. port until Sunday morning, and on top of that, she would not return home (where her back-up supply of medicine was kept) until late Sunday night.

The patient called us from an island the ship had stopped at for the day. The ship would leave port at 5 p.m., so we had to decide on our plan of action right away. Should the patient get back on the ship? Should she seek out a hospital on the island that could help? Or should she immediately charter a plane and fly back to the U.S., where a courier could meet her at the airport?   

Our team investigated all possible options, making calls to the pharmaceutical manufacturer, the cruise line, a nearby airport and even the Red Cross.

I consulted with the patient about her staying onboard and arriving in the U.S. as scheduled on Sunday. According to her calculations, she would need her next dosage of medicine by 10 a.m. on Sunday — right when the ship was scheduled to arrive. We could arrange for a courier to meet the ship as it docked, but that left no room for variables, like weather slowing down the vessel. That option cut it too close for our comfort.

When I talked with the patient, I learned she had a small amount of medicine remaining. I instructed the patient and her husband, step-by-step, how to mix a new concentration of medication using the small amount of medicine she had left and what settings to change on her pump. This would allow her enough time to enjoy the rest of the cruise and get home to her back-up supply of medication. I could hear the relief in her voice as she repeated the instructions back to me.

Fortunately, the ship reached the last port on time, her flight wasn't delayed and she got home with no additional complications. I know it was a stressful time for our patient and her husband, but thanks to our determined team, it was smooth sailing in the end.

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