One is Done

I'm home from my first Rituxan infusion. Overall, it went OK.

I got there about 9:25 for my 9:30 appointment. It's very rare that I'm not called in immediately, and by 9:50, I was getting anxious. I wanted to get started.

I had brought a laptop and a couple of movies -- Fanboys and Run, Fatboy, Run -- both fairly light comedies. I also brought a book, Bringing Down the House, which was made into the movie 21, about some MIT kids who count cards while playing blackjack in Vegas and making lots of money. Again, reasonably light. I held off on bringing any snacks, because I really didn't know what to expect, and I was trying to be conscious of other patients who might not do well with strong smells. (Which killed the whole idea of the provolone-stuffed olives that I had planned to bring.)

I wore my Jon Lester Red Sox t-shirt for good luck.

When they finally took me in, I saw Dr. R, who went over the procedure with me again and did a physical exam. He sent me off to the treatment room, and Isabel picked out a nice comfy chair for me. I had to sit directly in front of the nurses station in case there were any problems. (I can hide in a corner next time and watch my PG-13 movies in peace.)

The nurse was very nice. She gave me my pre-medication -- some Tylenol and a bag of Benedryl. The Benedryl, she said, would likely put me to sleep, and that I should just go with it and take a nap. I tried to do just that, but I couldn't get comfortable, and when I closed my eyes, I saw visions of really fast things rushing past me on either side. It wasn't pleasant. I kind of drifted a little for the half hour I was getting the Benedryl, but I never really slept. (Sorry, Lori. I know you wanted to have a vicarious nap through me.)

After the Benedryl, we started on the Rituxan. At that point, it was about 10:45. She gave me a small bag of it, and the drip was really slow. Everything went fine. I was still a little groggy from the Benedryl, and I asked the nurse to turn on the TV. I don't want to sound insensitive, but CNN's coverage of the Haiti disaster really wasn't what I needed. I drifted a little more, tried to read a magazine, and eventually had her turn the channel to Comedy Central.

By about 11:30, we were ready for a new bag of Rituxan. Still a little one, but she sped up the drip rate. Isabel ran to the deli across the street to get us some sandwiches. I ate half my turkey, and I was starting to feel a little funny. A little chilly, maybe. Afer a couple of minutes, it was getting worse, so I signaled to the nurse. She stopped the Rituxan and put me on saline. The chills got a little worse still.

There was only one prescription for that -- my new leopard-print Snuggy! (Thanks to my brother and sister-in-law for the Snuggy, and to my niece for picking out the leopard print.)

The Snuggy did help a little, but it was an allergic-reaction more than a chill. Dr. R popped in, and they gave me a steroid injection, which calmed it all down after a few minutes. They kept me off the Rituxan for another half hour to see if the steroid would do its thing.

When the nurse came back to see if we could restart the Rituxan, she asked me how I felt, and I told her I was fine. "Should we start again? she asked.

"Let's do it," I said, and took my left hand out from under the Snuggy so we could do an inspirational fist bump.

"Oh, good," she said, grabbing my wrist. "I wanted to check this," and she looked at the IV line in the back of my hand.

"No!" I said, still holding up my fist. "I can't believe you left me hanging!"

"I know what you wanted," she said," but I need to check this." She did, eventually, punch it, but the moment was frankly gone at that point.

We started up the Rituxan again, and the steroid did its job. No more chills or shakes.

Things went smoothly from there. I watched Comedy Central, and the nurses took turns coming out to see what I was laughing at. They apparantly don't get a lot of laughter in the treatment room.

I had one more reaction a little while later: an itchy rash on the left side of my lower abdomen and upper thigh -- right were I'm having the swelling and the problematic nodes. I don't know if that's a good thing, because it's working, or a bad thing because it means my body is resisting, or maybe just a coincidence (which seems pretty unlikely.) I told the nurse about it, who told Dr. R, who wasn't too concerned. We let it go until/unless it got worse, but it never did.

The other people getting treatment started to clear out by about 2:00, so we chatted with the nurses about dogs and kids and the Red Sox.

After the steroid injection, things went much more quickly. She started using larger bags and really speeding up the drip rate.

By about 2:45, she put the last bag on and said we should be done by about 3:30. That was pretty accurate.

Overall, not too eventful. The mice antibodies in the Rituxan did cause a couple of reactions, but they were manageable. The only other side effect was, as I was having those chills, I tried to think about something happy, and what came to mind was a fantasy involving Isabel dressed like Minnie Mouse.

The nursed said that next week, she'll do the steroid as part of the pre-meds, and there's a good chance I'll be done by lunch, since they can start at a fast rate right from the start.

Thank you all for your happy thoughts and prayers. Things look good.