Holidays on Ice
The summer after I completed my master’s degree, I decided to celebrate by seeing the world and improving my Spanish via a couple of months spent in South America. Planning this trip involved all the details any traveler would face: which destinations I would visit, which guidebooks to buy, which language schools to attend, and whether to stay in hotels or in home-stays arranged by the language schools. I settled on Ecuador and Peru, and in order to enjoy the privacy of hotels and the language immersion of home stays, I decided to alternate between the two. While it might seem as if I had everything figured out, because I have rheumatoid arthritis another question loomed large: how would I keep my medicine cold?
At the time I was taking bi-weekly subcutaneous injections of Enbrel, a medication that must be kept cold in order to maintain its effectiveness. The drug manufacturer provided me with a handy cooler for travelling, and I outfitted it with a refrigerator thermometer. I contacted all the hotels where I would be staying as well as all of the language schools arranging my home stays to make sure I would have continued access to a refrigerator. I had freezer packs as well as ziplock bags, so that as my freezer packs started to thaw I could maintain a cool temperature by filling the ziplock bags with ice, thereby keeping the cooler cold and my medication dry.
This plan worked beautifully on the flight into Quito, Ecuador, and the hotel I checked into was helpful in storing my medication in their restaurant’s refrigerator. Next I went to stay with a family for a week, and they had a refrigerator and freezer, so my medication remained cold during my stay and my freezer packs were frozen and ready to see me through the next leg of my journey, which involved a plane ride and a boat trip to the Galapagos Islands. For the first week of my stay in Puerto Ayora, the hotel once again was able to keep my medication cold in their restaurant refrigerator. I took a four-day cruise to see more of the exotic and unique animal species on other islands, and the crew was happy to keep my medication in the refrigerator for me. So far, so good. For my second week in the Galapagos, I did a home stay with a local family. Their house had many of the comforts I was used to, but was lacking some of the luxuries I take for granted in my daily life, such as hot water, a clothes dryer (the daily afternoon showers made it difficult for anything to dry completely on the clothes line), and a freezer. They did have a refrigerator, so my Enbrel stayed cold while I was with them, but without a freezer I didn’t have any ice or cold freezer packs for my cooler. However, on the day of my departure I figured that since the bus that would take me to the boat on the other side of the island left from the center of town, I would be able to get some ice from a shop or restaurant.
My assumption about the availability of ice proved faulty, as it was a Sunday, and almost all of the stores and restaurants were closed. Those that were open did not have ice cubes. As I went from vendor to vendor, I started to panic, as my bus would be arriving soon and my meds were warming up inside the cooler by the minute. I started to envision what the next month of my trip would be like unmedicated, and this only increased my panic. Still without ice, I saw the bus arrive. As soon as it parked, I explained to the driver in my broken, basic Spanish that I had medicine that must be kept cold, but that I couldn’t find any ice. The driver conferred with the operator of another bus, and they explained that I should go with this second man to get ice. So as my luggage was stored in the belly of the first bus, I was boarding the second bus, having no idea what was happening and hoping all would turn out well.
The driver and I were the only people on the bus, and he pulled away from the loading zone and zipped down the road. He began making twists and turns, driving as quickly as one can in such a large vehicle, leaving the town center behind and heading into a neighborhood, then entering an area where even the houses weren’t very close together. I began to get a sinking feeling in my stomach. Here I was, a female all by myself in a foreign island in the middle of the ocean, and I’d placed myself in a situation where I could easily be taken advantage of. The panic I’d felt regarding my medication began to morph into a panic for my safety. Yet, just as I began to feel truly worried, the driver parked the bus in front of a house, hopped out and spoke with some people inside, and then gestured for me to join. It turns out that in an exotic island where ice for beverages is a luxury, ice for fish coolers remains a necessity. The people in the house sold ice to fisherman out of their home, which they made by filling plastic bags full of water and freezing them to create giant ice blocks. They happily sold me such a bag, about the size of the bags pet stores place goldfish in. It just barely fit in my cooler, but it did fit, and now my medication would be cold.
With the most pressing problem solved, I now wondered how I would ever make it off the Galapagos Islands, as I was sure the bus that went to the other side of the island toward the airport had long since departed along with my luggage, meaning that I would miss my boat ride and my flight with no idea where my suitcase was. Yet, the driver hurriedly got us back on the bus and jetted off in an unfamiliar direction. Darting around pedestrians and people on bikes and pushing carts, the bus ride was more like a video game than public transportation. He continued zigging and zagging and turning corners until the back of the original bus, the one I needed to be on, was in view. The driver started blasting his horn and closed the distance between the buses. They both pulled over, I jumped off the bus after hastily giving the driver a big tip, and I ran and jumped on the bus I needed to be on.
My frantic morning had been full of worries that I wouldn’t be able to keep my medication cold, that I wouldn’t catch my flight, that my luggage would be lost, and that perhaps I had placed myself in a dangerous situation. However, because of the kindness of those two drivers, willing to be creative and inconvenienced in order to help me get the ice I needed, I made my flight with both my luggage in hand and my medication cold. While taking my final dose of Enbrel a few days before the end of my trip was a huge relief, as I didn’t have to deal with the headache of keeping a cooler cold any longer, in that moment I was grateful I needed the medication, as without it I wouldn’t have been privy to the knowledge of just how kind strangers could be to a lone, foreign tourist lacking language fluency. Rheumatoid arthritis confounds one with multiple frustrations, but every once in a while, it has revealed just how big some people’s hearts can be.
Right now, what RA tips would most be helpful for you?