Wednesday, September 19, 2012

Second round/end of week 5

I had the second round of Rituxan yesterday and am on way home now. In some ways it was easier and some ways it was harder than the first round. My dr agreed to let me try 1/2 the dose of steroids this time which would be the equivalent of 40mg prednisone. I started with some saline, iv benadryl and the steroids. Once the rituxan started I dozed for a bit and waited to get that horrible throat itching that I had last time at the one hour mark. This time it didn't come. But I started having some itching without rash and the nurse said she could call for more Benadryl. I hesitated but then agreed. But this one was an iv push and it hit me HARD.

I immediately became very dizzy and overwhelmed with nausea. The nurse upped the rate and I started having trouble breathing. I waved the nurse down and we stopped the infusion so that I could regroup. 15 minutes later I was feeling a bit better and we restarted the infusion. I felt pretty good after this point so we continued increasing the speed up to my max of 350. I probably should have had more steroids to begin with but really didn't want the 80mg. When we got back to the hotel I was having more post infusion reactions than I did last time, such as chills, aches, breathing felt weird. So over the course of a few hours I took an extra 20mg prednisone, putting my total for the day at 60mg. 60mg is considered the normal "stress" dose so I guess that's not surprising that ultimately that's what I needed. I was also in a state of utter exhaustion when I got back to the hotel and I think the initial lower dose of steroids could have been a factor.

I am trying to keep a regular regiment of Tylenol and benadryl for the next couple of days. Even with that I did not sleep well - was awake at 5am and took more of both thinking they would help me sleep. They didn't, mainly because my stomach started bothering me a lot. I had had a decent day and thought maybe i was getting things under control but I was apparently mistaken. Maybe taking the meds on an empty stomach kicked up the acid but it was not fun. I finally decided to go to breakfast and have some oatmeal to sop up some acid. I slept a bit more after breakfast but it wasnt a great sleep. I felt extremely hot for a bit with some burning skin sensations randomly dispersed over my body.  The hotel was nice enough to give us a very late check out so we just headed to the airport from there.  My stomach is really uncomfortable at the moment.

I was talking to a friend of mine who is a nurse practitioner in an oncology office and she said it is very common for her patients to have abdominal issues and be on ppis during treatment. Again maybe my pain is rituxan related. Can only hope it lessens again. I'm also thinking this has to do with motility issues that I had before ivig.

Another weird thing that has happened that may or may not mean anything but I thought I would at least report it has to do with my hands. Before my second round I noticed a couple very small blisters on my right ring finger. They really hurt and are fluid filled. Again they are tiny. Today I noticed a couple more starting on other fingers. I will see the dermatologist when I can and get his thoughts on them because they are painful.

Looking forward to recovering at my own house soon.


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