Today I did my first infusion with Gammagard SD. I left the supplies and Gammagard in the box until yesterday morning, then I decided we were close enough to infusion time to set things out. I pulled out the gammagard boxes and got a bit of a scare. I knew that the medication was in powder form, and one of the ice packs had burst inside the styrofoam ice chest that it was shipped in. The Gammagard was packaged in plastic, but nevertheless, the ice-pack goo had soaked into the boxes--at least two of the boxes were moisture-soaked and splitting open. I was honestly afraid that the powder would be ruined and I wouldn't be able to do my infusion. I called Accredo to tell them what happened, and spoke to the warehouse manager. She informed me that the medication would not be compromised because it was sealed in a bottle within the package. I opened it up while on the phone and confirmed that the medication was all fine.
It was really interesting mixing the Gammagard. It is a powder that comes in a glass bottle with another bottle that contains sterile IV water. The nurse had me transfer 96mls of water to the powder bottle using a 60ml syringe. After combining the two, we had to let the powder mix in to the liquid. We couldn't shake or stir the powder in, and simply had to roll the bottle to gently mix the powder in. It took about an hour from the time that we combined them until the Gammagard was ready to infuse. The total volume that I infused today was 110 ml, and I'm honestly not sure how many hours it took. The rate tubing that they gave me was very slow (as subQ rate tubing goes) at 120ml/hr, yet the infusion was much too fast for me. My legs (where I put the needles) were stinging and turned red and swelled significantly, although it probably wasn't as bad as on my stomach. I also was having some breathing trouble. When I showed my nurse the infusion sites, she had me turn off the pump because she said it was going too fast and that I wasn't absorbing the medication fast enough to keep up.
So...in addition to my infusion, my mom was having a crisis. For about 10 days she's been having trouble walking with one leg hurting and feeling heavy. Suddenly, yesterday before the nurse arrived, her leg started hurting so intensely that she couldn't put any weight on it. She came to my room using a carpet sweeper as a crutch. I had her lie down on my bed and we propped her leg up on pillows. I didn't know what to do as I was unable to drive (license taken away due to seizures), and I couldn't leave before my nurse showed up. When the nurse arrived I filled her in on my mom's condition, and she was concerned too. She said that if no one else could take mom to urgent care, that she would take both of us in after we got my infusion started.
The nurse arrived at 3:15, and because of waiting for the medication to mix and some things I had to do to get ready, it was at least an hour (maybe 2) before we started my infusion. She wheeled my mom out to the car in my wheelchair, and I put together an emergency bag for my infusion to take with me. Because I was infusing 110ml of fluid and the pump only accommodates 60ml, I had to take an extra syringe full of medication with me and ended up swapping out the syringes in the office at urgent care. We were at urgent care for 2-4 hours, and then sent to the ER. My nurse then drove us over to the ER, and she told the check-in nurse that we had to leave my mom there (mom was all for this) because of my immune deficient state. My nurse insisted that we get something for mom to eat before leaving, as by that time it was about 10:00 PM and none of us had eaten. She and I ran over to In & Out (nearest open place selling food) and she bought dinner for all 3 of us, then as we got in the car, a man knocked on her window and asked if she could jump-start his car. She turned the car so that the headlights were on his car and gave him a jump-start. She was very smart about it though, she popped the hood of her car from the inside and locked the doors. Turned out he was just an honest guy with a dead battery.
After we dropped the food off with my mom, my nurse took me home and then headed home herself. I couldn't believe how gracious she was about everything all day, and she maintained a good sense of humor too!
I was worried about how my mom was going to get home. My brother lives in the area, but I couldn't reach him by phone, and my boyfriend lives 50 miles away and would have come except that he was sick and in pain himself. I'd given mom cab fare, but wasn't sure how she was going to get in when she wasn't even able to walk. I heard one of our roommates get home, and I told him what had happened and asked him if he happened to hear her outside if he would let me know (his room is by the front door). He promptly offered to go pick her up and asked me to call her. I did, the doctor had just finished seeing her, and they released her. He went to pick her up and they got home about 1:00 AM.
People were really wonderful yesterday! 
About 2:30 AM I started getting a migraine (despite lots of hydrating in advance), so I took a Fioricet, and aside from some weakness and tiredness, I feel pretty good today!
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