Tuesday, November 10, 2009

Ghosts And Globulins

Today.....CT biopsy.

Maybe Friday (waiting for confirmation from the doctor's office), the latest "next event." Seems like some parts of the whole blood thing have not fully bounced back. As part of my follow up, it is required that a IgG level was required after day 100. IgG level testing is to assess the amount of immunoglobulin in my system. If it is below a certain level, then it needs to be replenished. Today, the doctor called and told me that my immunoglobulin was below the minimum level and I would require an infusion (IVIG). They will occur once monthly for the next three months. As I understand it, this is not all that unusual of an occurence for a transplant patient. The what and how follow.

Immunoglobulin - "A protein produced by plasma cells and lymphocytes and characteristic of these types of cells. Immunoglobulins play an essential role in the body's immune system. They attach to foreign substances, such as bacteria, and assist in destroying them." - http://www.medterms.com/script/main/art.asp?articlekey=12077

IVIG - "A sterile solution of concentrated antibodies extracted from healthy people that is given straight into a vein. It is used to treat disorders of the immune system, or to boost immune response to serious illness." - http://www.medterms.com/script/main/art.asp?articlekey=11530

The first IVIG infusion is tentatively scheduled to take place this Friday. I will confirm with the doctor's office this AM. It will take place in the chemo room at the clinic where I received my first 9 chemo infusions. They asked me what office location I preferred to go to for the infusion and I told them I wanted to go wherever the people who administered all of my previous chemo treatments would be. I'm not sure they'll be as thrilled to see me as I will be to see them, but Friday is the day after the one year anniversary of me receiving my first chemo treatment.

Side effects: "The majority of side effects are mild, transient, and self-limited and do not require discontinuation of therapy.The most common side effects are:
* headache
* myalgia (i.e. muscle pain)
* fever
* chills
* backache
* chest pain
* nausea and/or vomiting

Fortunately, most patients with these side effects can be helped by slowing down the rate of infusion. Premedication with acetaminophen, antihistamines, or occasionally steroids can also help decrease side effects.

Serious adverse events such as aseptic meningitis, thrombotic events, and renal dysfunction have been reported to occur in association with IVIG." - http://www.immunedisease.com/patients-and-families/ivig-therapy/ivig-side-effects.html

The infusions take about 5-6 hours per infusion, so there will be plenty of time for chemo room hi-jinks. Since my last trip to the chemo room was in May, I hope it's like riding a bicycle, i.e. once you learn how to misbehave in the chemo room, you don't forget.

After the infusions, there are no limitations on physical activity and no drop in blood counts, etc. as there was with chemo.

Just when I thought there wasn't more stuff to learn about all of this.......

2 comments:

Sarah said...

We give lots of IVIG to our heart transplant patients who are in rejection...they tolerate it pretty well. Bummer that they took your port out already, though...

Greg said...

Sarah, Actually the power port is still in me. Whew! It was the Quinton Port that was removed when I finished at MCV.