I first started doing mix kits when I was put on Remodulin (subcutaneous) back in 2015, and I still do them even after I’ve been switched to Veletri about a year ago. They are such a great resource and help the mixing move so much more quickly than without one.
A mix kit is a large bag that has all the necessary items you’ll need for 1 mix of whatever PAH medicine you are on. I assume this would work with any medicine pump user, though I can only speak for my experience with PAH. 🙂
A little background: Veletri is a PAH medication that arrives in powdered form. It is up to the patient and their care team to decide what concentration the medicine should be at for optimal PAH symptom control. Every day the patient will need to ‘mix’ the Veletri powder with sterile water in order to reach the concentration they need. There are specific items you will need every time you do this, and we put the items into a gallon bag for ease of access.
The picture above is an example of the mix kit I currently use for my Veletri. You might notice some of the items I uploaded in Monday’s “What I Order Each Month With My Veletri” post.
An important note that I’ve mentioned before – I am incredibly lucky that my mom is the one who mixes for me every day. When I was in the hospital last year, learning how to change the pumps and mix the Veletri and acclimate to the drug itself, my mom had a clearer head than mine. She was able to become really proficient with the mixing whereas I would struggle and get frustrated easily. Now that I am out of the hospital, I can mix without an issue. However, my mom has been kind enough to continue to mix for me every day – sometimes multiple times a day if something happens. She’s amazing and I am so grateful.
When it’s time for us to mix, we wash our hands really well and sanitize our mixing table with alcohol. Then we grab a mix kit and get to work.
Having a mix kit limits the amount of items our hands touch when mixing, as well, so you’re not having to re-sanitize your hands as frequently. Hand sanitizer and rubbing alcohol are must-use items when you are mixing. Both can dry out your skin rather quickly though, especially in the colder months!
We keep all of our mix kits in a drawer right next to our mixing table. With all the supplies I receive each month for the Veletri, we are able to make about 25-28 kits. I am stupendously lucky that once a Veletri order comes in for the month, my mom will put all of these together for me.
The white drawer system has all the supplies we need for mixing, changing out pumps, and dressing changes. We use the table and cookie sheet each time we mix or change pumps. It’s a sturdy table that doesn’t have a finish on it so when we use alcohol to sanitize the top, it doesn’t get damaged.
Each mix kit is identical to the one next to it, as the items inside are needed every single time we mix the Veletri. If something goes wrong or a supply is damaged, we can grab another kit quickly and replace what we need after we are done mixing.
Starting from the bottom left and going counter clockwise:
10ml syringes: These are the big mama-jama syringes that help extract the Veletri from the vial and expend it into the cartridge pump
BD Q-Sytes: An attachment that hooks on to the Veletri vial itself with a syringe connection on one side.
Veletri Vials: Self explanatory. For the concentration of medicine I need, we use 3 vials of Veletri to mix every day.
Veletri Cartridge: This is the plastic container that holds the mixed Veletri. The container hooks to my pump and I wear it all day (or night).
Sterile Water/Diluent: What we mix the powdered Veletri with
Sandwich Baggie: We keep the mixed and ready cartridge in the fridge to keep the medicine cool. In order to keep it as safe as we can, we put it in a small baggie.
Alcohol Swabs: Self explanatory. We use these to sanitize the tops of medication vials and other items needed in the mix kit.
Spikes: These are what go into the sterile water vials. It has a spike on one end and a syringe connection on the other so we can use the syringe to pull out the water.
Do you keep mix kits? If you don’t, I really encourage you to, or have a caregiver make them for you. It’s a bit of front-loading at first but it really simplifies the mixing process. Let me know if you have mix kits or if you want to make them in the comments!