My November '11 Appointment with the Immunologist

I saw my Immunologist yesterday, and I was able to put my mind at ease over some of my concerns regarding stopping my infusions. I have been worried that I had no antibodies to the kinds of diseases that children get immunized for, and my immunologist showed me my most recent test results (2 months after stopping infusions),  and said that I have antibodies to those diseases. The part that I'm lacking is in defense against pneumonia-causing organisms like mycoplasma and other nasty things like that. He said that it's actually pretty common for CVID patients to have antibodies to most other diseases and just be lacking in defense against pneumonia. That really puts my mind at ease.

The one thing I forgot to ask him about is my hair falling out. I am a woman with long straight hair, and I wash it, condition it, and comb it. Lately it's been falling out by handfuls. I'm getting concerned and don't know whether it's CVID related. However, there are quite a few people in my support group who have the same issue.

I have now been off of my infusions for 6 months and off of Trileptal for 4 months, so yesterday they did some bloodwork to determine whether my antibodies are recovering now that I'm off of the Trileptal. I should know the answer in a few weeks! It would be so amazing and wonderful if I could recover and not have CVID. Of course, I may still be IgA deficient after this, but that would still be better than full-blown CVID!

On the downside, I'm on my 3rd round of antibiotics (in addition to the prophylactic ones) to kick what I believe is pneumonia. Originally I was sick for 4 or 5 days and seemed to recover on my own. I thought it was a good sign. Then about a week later I realized that I had not only a sinus infection but that it was moving into my lungs. I called for antibiotics, and they told me to take triple my normal dosage for 4-5 days then call to let them know how I was doing. I called on the specified day, and since I seemed to be feeling better and hadn't heard from them, I dropped back down to my maintenance dose the next day. That night I went to bed early and woke up about 9:00 PM with significant chest congestion. I made myself some hot lemonade to help loosen my chest up, and went back to bed. When I woke up the next morning I was so sick and so weak that I had difficulty walking just the few feet to my bathroom. I called the Dr back and they said to take double my normal prescription twice daily for 3 weeks (that was a week ago). I've done that, and have felt my strength returning, but I'm still so weak that I need a wheelchair rather than walking any distance. When I saw my Dr yesterday he believed that I could well have had pneumonia, said I was very pale, and put me on a 3-week course of Cipro. He said it's good at fighting all the nasty little beasties that cause pneumonia.

I started the Cipro today, so hopefully I'll feel much better in a few days/weeks.

Gammagard 5 (almost sounds like a band name)

I had my fifth Gammagard infusion yesterday. It went pretty well, and there was no vomiting this time. We got off to a late start with it, and so the infusion didn't start 'til 6:00 PM, then I spaced out on changing the syringe halfway through, and so the infusion didn't end until 2:00 AM. I think I need to set a timer for changing it.

I took my benadryl at the very start of the infusion. That's the best way that I can insure that my brain won't be foggy when I'm setting everything up. I'm a small person, and 50mg of benadryl is mentally overwhelming for me. I have a hard time following a plot on a tv show on 50mg of benadryl, let alone giving myself an infusion!

This time though, my boyfriend put all the needles in me. He's squeamish about needles, but does it to make it easier for me. I very much appreciate it, as it relieves a lot of my stress.

I had some breathing trouble during the infusion, but it was very slight and I took my rescue inhaler at the start and every 4 hours during until I went to bed. I also took another 2 benadryl and 2 tylenol 4 hours into it.

Today I feel weak and tired, but after 4 benadryl yesterday, I'm really not surprised by that. I'm continuing to hydrate well, and don't have much pain other than waking up with a headache that more tylenol seemed to help. I've pretty much spent the day in bed.

I'm continuing to hope that my infusions will get better and easier and I'll start needing less medication during them. 

Doctors and Insurance Companies

Yesterday I was chatting with a friend who has been fighting with her insurance company for a year to try to get coverage for infusions, and she told me that they had finally agreed to cover her for a year!!! I'm so happy for her because she's been so sick for so long, and constantly had trouble finding doctors who would help her. It shocks me that so many members in my favorite support group have had doctors refuse to treat them once they found out that the person had CVID! Makes me think they swore a hypocritical oath rather than the Hippocratic oath! Sometimes these doctors will admit that the case is too complicated for them...but don't they consider referrals at least??? I mean, we CVID patients are desperately seeking relief from pain, gastrointestinal problems, breathing problems, skin problems and doctors just say "You're too complicated, get out of my office!"? What's wrong with this system?

Update

The specialist called and told me that they've started the process of authorizing the switch from Hizentra to Gammaguard SD with my insurance company. They are planning to have me start at one treatment a week. She also said that the specialty pharmacy (Accredo) said that if my insurance is cooperative then I could be transitioned in a as little as a few days. I'm planning to just skip treatment this Friday since even if it all gets approved this week, they won't be able to get the supplies to me in time.

If my insurance company causes problems or drags their heels too long, I might have to go back to doing Hizentra, but the doctor said that they'd give me steroids so I could get through it without a reaction. I really hope that doesn't happen! Wish me luck people! :)

Even though it's now days after my last infusion, my legs where I inserted the needles are still very itchy, and I'm getting a rash there. Last night the sites were lumpy, not from a build-up of medication this time, but from the rash.

Fourth IVIG Treatment

I had a smooth infusion today. My doctor asked the infusion nurses to give me the hydrocortisone before the Benadryl to prevent the strange reaction I had yesterday. I had no reactions, and slept for the first 3.5 hours of the treatment. The entire thing only took 4.5 hours...my fastest yet!


Last night I drank 66oz of both Pedialyte and Smart Water , and was in a much more positive frame of mind for this treatment.


I slept 3 more hours after having lunch when I got home. and after I woke up I had the sudden hunger that I always seem to get after my treatments. I had a healthy dinner and raspberries for a snack, and I actually feel ok and have a little bit of energy. It's kind of encouraging! I'm not holding my breath on the next few days being great, but I'll take it one day at a time. I have a headache and body aches, but they're minor. I think I'll take a little Benadryl tonight.