I suggest to call the hotel before you book to make sure that the room's fridge has a freezer compartment to put the biogel. One time I had one without freezer, and ended up using hotels ice for next day until the next destination. My experience with the travelcase that I bought is: as long as you are indoors with AC, it'll keep the temp for up to 16-18 hours. I haven't used it for longer than that. There was a person posted online that he tested his travelcase( with a used forteo pen inside) exposed to room temp for every hour, he had a summary of changing temp inside the cylinder. I forgot where I read it. But if you are curious, you could test out with a regular pen. The thermometer is kept in the cylinder/travel case with the pen.

Also pay attention that it might be best to keep the pen in the middle of a refrigerator, not by the door or at back or corners, or near the freezer compartment of a hotel's fridge. You wouldn't want insfficient cooling, or overcooling that makes the pen freeze. Do adjust hotels refridge upon arrival to make sure temperature is cold enough.

I haven't noticed any pens that were cloudy. It should be easy to see since the barrel is clear and big (its circumference is bigger than my thumb). Once i saw a small bubble but there is no way to get it out. The bubble doesn't appear to affect the dose delivery.

Supposedly, you could ask for a pen replacement if there is any defect or it came with cloudiness. The shipment is fast via fedex overnight and comes with many frozen ice packs inside a thick foam box. The shipment doesnt have an alert system/sticker to indicate that temperature had been breached (some critical biologics needs that to ensure potency). But i did read somewhere forteo is fine for uo to 30 hours at room temp (double check on this info). Do double check with your specialty pharmacy regarding shipment for ease of mind. I had mine delivered every 3mo to save time and my insurance allows 3mo dispensing.