Medications for a hurricane: how to prepare in Puerto Rico

The Atlantic hurricane season runs from June 1 to November 30. It peaks around September 10, with most activity from mid-August to mid-October, according to the National Hurricane Center.

Before it starts, prepare:

When a storm is forecast, pharmacies get crowded and may close if the power goes out. Don't wait until the last days: count how many days of medicine you have left and refill early.

If your prescription has expired or you can't reach your doctor, you can see Dr. Diana Nieves Castro by video. She is a general practice physician licensed in Puerto Rico with several years of emergency-department experience. For a prescription refill of a medicine you already take, she reviews your treatment and, if appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances. If your diabetes or blood pressure hasn't been checked in a while, we give you a lab order for a lab near you; see chronic care.

After the storm we also see you for a new problem that is not an emergency, such as an infection, an upset stomach or a small wound: that is virtual urgent care. We evaluate, diagnose and treat adults and children of all ages, in English or Spanish. If your medicines were lost, see what to do about a lost prescription.

You need to be physically in Puerto Rico during the visit, and visitors are welcome. For patients under 21, a parent or legal guardian stays on camera for the whole visit and shows photo ID.

Request a visit online 24/7 — we confirm your time by email or text.

A follow-up visit costs US$49 and covers a refill of a medicine you already take. A new problem is a doctor visit, which costs US$79. If the doctor finds during a follow-up visit that you need a full visit, she explains why and, with your consent, you pay the difference.

The price is the same for every age, with no membership. Your card is charged when you request the visit, and you get a full refund if the visit can't take place. A doctor's note after your visit is included at no extra charge. The service is run by The Health Initiative, a nonprofit. See pricing or book your visit.

According to the FDA, insulin in the manufacturer's vials or cartridges, opened or unopened, may be left unrefrigerated between 59 °F and 86 °F (15 °C to 30 °C) for up to 28 days and still work.

Keep it as cool as possible, away from direct heat and sunlight. Do not use insulin that has been frozen. Once you have properly stored insulin again, throw away vials exposed to extreme temperatures and replace them as soon as possible. If you are unsure about a specific insulin, call the manufacturer. If you have type 2 diabetes, review your plan with the doctor before the season.

For other refrigerated medicines, ask your pharmacist before the season what to do if the power goes out. Also ask your pharmacy and your plan whether they allow early fills during a declared emergency.

If you have diabetes, high blood pressure or asthma, use oxygen or are on dialysis, prepare this before the season (based on Ready.gov):

Our visits are by video; we don't do phone-call visits. If the signal is weak, connect from the spot with the best coverage, close other apps and charge your phone ahead of time. If the visit can't take place, you get a full refund.

Never run a generator inside your home or garage, even with doors and windows open. The CDC says to run it outside, more than 20 feet from windows, doors and vents, and to keep a battery-powered carbon monoxide detector at home. If anyone near a generator has a headache, dizziness, nausea or confusion, get outside and call 911.

Put children's medicines on the list with their recent weight, since many doses depend on weight, and include the medicines of older adults in the household. If anyone relies on oxygen or other powered medical equipment, talk to their provider before the season about a plan for power outages.

If you ran out of an essential medicine and feel unwell, have chest pain or trouble breathing, or got a deep or dirty wound during cleanup, don't wait for a video visit: go to the ER or call 911. See when to go to the ER.