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Rituxan Shock

     January 7th, 2004.     

     Today I went to get a Rituxan treatment, and what a ride!

     The first thing that happened was I got lost. Last week, I went to the hospital for my MUGA scan, and I just thought the Rituxan treatment would be in the same place, so I went there. They directed me to the Radiation Oncology Center down the street, so I went there. They said they had no idea who I was and didn't see an appointment for me, so they called my doctor's office, and was told that they do the treatments right in the doc's office. Good thing they're all in the same neighborhood!

     So, I checked in at the doc's office, and presented my shiny new insurance card. The company I work for changed insurance carriers from CIGNA to Blue Cross Blue Shield on January 1st, and I figured they'd need a copy for their records. That's when I found out that my co-pay went up, from $20 to $30. It's not that big a deal, and I paid up.

     I grabbed a magazine and followed the nurse to a back room, where I found the familiar overstuffed easy chairs and IV trees. I was the first one there this morning and had my pick of where to sit. I plopped down in the nearest one and put a pillow on my lap so the nurse could set up the IV for my drip.

     She had some questions for me about my past experiences with Rituxan and drugs that were used in conjunction with it and with chemo I'd already had.  One of the questions she had was about the drug given to me in the past to keep the nausea down.  I couldn't remember the name, and none of the ones she mentioned rang any bells, so I told her she could get online and have a look in my journal to find it.  I told her it would be under the first COP treatment I had, and in short order she narrowed it down to my journal entry titled, "Chemo Man".  There it was: Torecan.  She said she'd never heard of it, so I told her to use whatever she wanted to try.

     She also asked about any drugs they'd used for the Rituxan treatment, and I remembered the Benedryl, cause it made me so sleepy, and the two Tylenol.

     Then I threw her for a loop, but I swear I didn't do it on purpose.  She asked if I'd had any problems with the Rituxan, and I told her "nope".  I wasn't thinking...  It had been over two years since my first Rituxan treatment (in the update near the top titled, "More hospital").  In that very first treatment, I'd had a strong reaction initially.  The nurse at the time stopped the drip, gave me more Benedryl, then started up the drip slower, and increased it as we went along until I finished.  I had no further problems.  The following Rituxan treatments over the next few weeks were entirely without incident.  I just forgot all about that very first initial reaction.  I should have remembered and told her...

     So, she set me up with the Benedryl and Tylenol, then started up the Rituxan.  By then, a few other patients had come in and were getting set up as well with whatever their drips were.  One lady had a port, while the rest of us were getting it through an IV.  I was comfortable and reading a magazine, when I started to feel just a tiny, little bit warm.  I didn't think too much of it though at the time.  A few minutes later though, and I started to really feel uncomfortable, and started to cough strongly.  The nurse came in to see what was going on, so I told her.

     She immediately stopped the drip, but now I was on a roll.  It came over me so fast, I just didn't see it coming.  I got really hot, and my face and throat started to itch as she called out to the front desk to call 911.  More questions and the memory of my very first Rituxan and the initial shock to my body from it flooded into my brain and out my mouth.  It seemed to make her a little angry that I didn't tell her before we started when she specifically asked if I'd ever had any trouble with the Rituxan.  Oops.  My bad.

     It got difficult to breath, and I felt like I was about to pass out, and she hooked me up to oxygen.  I was having trouble making intelligible words and there was no doubt I was in shock as another person that works there took my blood pressure and pulse.  It all happened in just a couple of minutes and scared the hell out of everyone.

     By the time the paramedics arrived a few minutes later, I was feeling much better.  Not quite up to par, but I was pretty sure I was going to survive, and was feeling even better by the minute.  The nurse was still looking pretty anxious though.  As they hooked up electrodes and took my BP and pulse, she explained to them what she saw from her perspective.  She said I was pale, clammy and they couldn't get my vitals, then I passed out for a little while.  No wonder she looked upset!  I musta looked like I was about to die for a few minutes there!

     The paramedics wanted to take me to the hospital for a full exam, but I declined.  They suggested I really should go there and get checked out to find out what happened, but I declined again as I continued to regain my strength and composure.  I knew what it was already, as the first Rituxan treatment I'd ever had flooded back into my brain.  They had me sign a form that said I declined to go with them, explaining to me that I was 'taking my life in my own hands'.  I was okay with that, and off they went to rescue the next person.

     Just after that, the doc showed up and agreed with the nurse that they wouldn't be giving me any more Rituxan today.  I was a little disappointed at that decision, as I really wanted to finish, but I understood their concern and didn't give anyone a hard time about it.  They're the pro's and they know what they're doing.

      After talking with the doc, the nurse said we'll still do the CHOP tomorrow, but the Rituxan will be done in a hospital facility where they have all the necessary equipment to deal with any emergency that might come up.  She didn't want a repeat of this morning's antics, and I couldn't blame her.

     I sat there for awhile, letting the Benedryl wear off a little before attempting to drive.  When I got home, I was pretty beat.  I took a restless nap, got up and had something to eat, then another nap.  What a day!

     Mom's coming out to visit and help with what she can.  She should be here within the next few days, maybe as early as tomorrow, if she can get a flight out.  I guess I should clean up a little around here...  Hehehe... the place is a mess!

     Tomorrow I'll get a CHOP chemo treatment at the doc's office, and I'm sure everything will go fine.  I'll update when I get home from it, and let you all know how it went.  See ya then!

     Next: CHOP It 
                                                            Buck