Thursday, July 26, 2018

Greg's IVIG Treatment

So, we've gone through six IVIG treatments for Greg so far and they have been going very well.   I was pleasantly surprised that everything went through our insurance at what I consider to be record speed!  All the authorizations were completed and approved without issues or a lot of work on my part, which was fabulous!  

IVIG is intravenous immune globulin.   Immunoglobulin is part of the blood's plasma and has antibodies in it to fight germs or disease.  When people donate blood, this part can be separated out and can be given to a patient in an IV or subcutaneously (under the skin, but not in a vein) to help strengthen their immune system so they can fight infections and stay healthy.   It can take between 1,000 and 15,000 donors per batch.  In Greg's case, his immune system hasn't been normal since his bone marrow transplant in 2000.  That's really not unusual.    

For anyone that's read my blog for any length of time, you already know that Greg has had a lot of infections.  His sinus infections were almost constant, which was why he had the sinus surgery late last year.   Thanks to the suggestion of our wonderful Case Manager, Jeanne, we went to see an immunologist and discovered that his IGG levels were indeed low.   So, it was time to set up the IVIG treatments to see if we could boost that and get Greg finally to a place where he's not sick all the time!  

We received a box of supplies via Fed Ex.  These are all the supplies and medicine we should need for a month's worth of treatments.   The picture on the left is all of the supplies in a plastic tote I bought to keep everything organized and away from the cats and dogs.    The picture on the right is what needs to be used for one treatment:  alcohol wipes, bandages, gauze pads, the Immune Globulin, a sterile drape to put everything on, two 60 CC syringes (he gets 50 cc's from each bottle of Immune Globulin), a subcutaneous infusion set (the "lines" that are used to infuse), five transparent film dressings to place over the needles so they don't pop out (like what is used over an IV), a mini transfer pin, which is used to transfer the Immune Globulin from the bottles to the syringes, a sharps container for the needles, the infusion pump and even an Epi pen, in case he ends up having a severe allergic reaction, so I can stab him in the thigh while I call 911!    




The home health nurse came to our house three times.  The first time, she instructed me on what to do while directing me on how to do it and the next two times, I handled the treatment with her just watching and answering any questions we had.  I've now given Greg his treatments twice without the nurse and it's gone quite smooth.  









It all starts by getting the serum into the syringe.   That funky thing on the bottle is the "mini transfer pin" mentioned above.  













Then the syringe is attached to the end of these.  These are called an "infusion set." There is a tiny needle on the end of each of those 5 lines.  














It's kind of hard to see in this picture, but the needle is what my index finger is kind of pointing to.   It's really tiny, and thinner than a standard straight pin that you would use for sewing.  













To insert the needle, you simply have to grab a bit of your love handles and, after cleaning with an alcohol wipe, insert the needle.  Greg has said it's much like a mosquito bite.   There are five needles in all, so we put three on one side of his belly and two on the other and cover with 











Once all the needles are in, the syringe is placed in this infusion pump.   It takes about 30 minutes for one syringe.  Once that one is done, we simply attach a new syringe to the end of the infusion set and put it in the pump.  Another 30 minutes, and we're done!  













This is what it looks like when the medicine is being infused.   












He ends up with a bit of a bulge where the needles are located, which is normal,  but that usually goes away by morning. 








So, that's what his IVIG treatment is!  This is definitely an expensive treatment, especially when it's done weekly.  The cost for one treatment is $4,081.  If we are going to continue these treatments weekly, one year will cost $212,212!    But, if it's going to keep him from getting sick, then it's certainly worth it! 

Thank goodness we have wonderful health insurance.  I'm glad United HealthCare did not take this into account when they hired me because they are certainly on the losing end of the financial stick!!  Ha, ha!
   

Hope all is well for everyone!  

Peace and Prayers for all! 

Julie