My Monthly Dose of IVIG

Intravenous immunoglobulin (IVIG) is a blood product prepared from the serum of between 1000 and 15 000 donors per batch. It is the treatment of choice for patients with antibody deficiencies. IVIG temporarily increases the platelet count in about 80 percent of ITP patients.

If antibody levels become too low, doctors sometimes recommend that people with lymphoma receive intravenous immunoglobulin (IVIG) to bolster their immune system and help protect them from infection.

IVIG is produced by pooling antibodies from thousands of blood donors. The antibodies are purified and sterilized to prevent the transmission of any infection.

What does it involve?
IVIG is administered via intravenous infusion in a medical setting. IVIG treatment is commonly given once a month while antibody levels are low. Antibody levels may rise with effective lymphoma treatment or recovery from chemotherapy or stem cell transplant. As Ig levels rise, you may need IVIG less frequently.

COMMENT:  Since I am being treated with immunotherapy for both Non-Hodgkin's Lymphoma and Metastatic Melanoma, my Oncologist has recommended that I be given IVIG on a monthly basis to bolster my immune system, my low platelet counts, my anemia, and my constant sinus infections, and facial infections that have resulted from over a decade of cancer treatments.

I notice a change after each treatment in that my overall mental and physical health seems to be more vibrant, although that could be psychological...  and if it is, I really don't give a damn because the bottom line is that I feel better.  The only downside is that all my treatments come with steroids and that keeps me awake at night and since I have chemo treatment the next day EARLY...  then I need to fall asleep quickly.

Two Weeks Free

Starting tomorrow, I have two weeks completely free of doctor's appointments which is highly unusual...  to say the least...  What I do have scheduled in three weeks is I will be starting my monthly IVIG infusions and the following day, I will have my chemo treatment after visiting with my Oncologist for a few minutes.  Actually, he spends whatever time he needs to spend with me, in order to answer all my questions to my satisfaction.  I usually not have any questions unless he is going over the results of a recent CT scan.  My last scan was April and it was a CT scan so around July/August, I should be scheduled for a PET scan.

So...  what do I do with so much time off?

Well...  I will be working out in the yard mowing and weed eating, staining the new deck boards I replaced last year, draining-cleaning-refilling the hot tub while making sure that everything inside the house is squared away as well.  Interesting how since 1972, I still use military terms.

Most of my days will be occupied posting articles to my blogs and adding pages to my 4th novel...  and NO...  I have no plans in seeking out a potential publisher...  I have always wanted to write a novel and now I have almost written 4...  and these are not short novels...  at least 300 pages or approximately 75,000 to 90,000 words.  I had no idea that I was so talkative...  lol

Immunoglobulin Therapy

IVIG is made from the antibodies of blood from about 20,000-30,000 people or so I was told by one of the nurses who administers the infusion.  These infusions help boost the immune system of patients who have low immune system protection due to on-going cancer treatments.

In previous years, many of the people who died of cancer actually died from contracting other diseases as a result of a low immune system and not from the actual cancer itself.

IVIG stays in the body for about 3-4 weeks and I was receiving monthly infusions every month until the healthcare industry started experiencing shortages and my treatment was stopped because I was not experiencing a life threatening situation.

After about 18 months of not receiving any IVIG treatments and because I was getting constant infections, I was put back on receiving IVIG every other month which only had minimal influence.  My Oncologist last month said he was writing an order for monthly IVIG infusions and I will find out today if that order was approved.

Back Home

My early morning visit with the Oncologist had me back home before NOON toady with good news...  There has been NO PROGRESSION of my two cancers and a lesion on my lung has actually disappeared which is good.  The lesion on my liver is benign and seems to be a collection of blood vessels so there is no need to do a follow up MRI unless it starts increasing in size and it is doubtful that it will increase but one never knows.

My blood work continued to show that I am anemic, have a low immune system because of a low white blood count, and my platelets continue to be about 2/3 of what they should be...  so, basically I have remained consistent month-after-month for the last two years...  and, because of all the infections that I have been experiencing, my Oncologist wants me to receive monthly IVIG treatments and since it is too late for anything this month, and since I have a treatment scheduled for May, my monthly treatment will begin in June...

All-in-all, it was a good report.

What was really encouraging was the fact that apparently my gastrointestinal doctor sent my colonoscopy results (which included his concerns about a lesion on my liver) to my family doctor who in turn had corresponded with my Oncologist about those concerns...  and now, my Oncologist will follow up with my family doctor to let him know that the lesion on my liver is a benign collection of blood vessels...

I like it when the system works and doctors are interlinked and actually correspond with each other in order to ensure positive patient outcomes.

Oncologist and Treatrment

Today, is my monthly visit to the Cancer Center for my Opdivo treatment.  Every other month, I see my Oncologist and this is one of those days.  I will also be told of the results of my recent CT scan and I am particularly interested in the lesion on my liver as reported by my gastrointestinal doctor after a recent colonoscopy.  He wanted to do an MRI, but when I shared that info with my Oncologist, he said that we would do a CT scan first since I was on the schedule to have one soon.

The other issues that I have with my Oncologist revolve around whether or not I am going to be receiving monthly IVIG treatments instead of every other month.  And, the reason why I an concerned about this is that my sinus infections return the month I am not receiving IVIG treatment, plus my Dermatologist just prescribe medication for a skin infection on my face that has gotten down into the hair roots.

I get to the Cancer Center about 7:30 am and by the time I am done, I am typically leaving around 10:30 am...  strange how it takes me 3 hours to have lab work taken, see my Oncologist and receive a 30 minute treatment...  one would think that each area should take no more than 30 minutes including the wait...  or, about 90 minutes and one can stretch that to 2 hours just to make sure...  but, it takes me 3 hours...

Labs and OPDIVO

Every 4 weeks, I have my OPDIVO infusion to regulate and control my Melanoma Cancer that I have had for about 6 years...  and, while no one will point-the-finger, the literature indicates that contracting Melanoma is entirely possible as a side effect of taking chemo drugs:  Cytoxin and Fludara.  I received both Cytoxin and Fludara for 6 months when being treated for non-Hodgkin's Lymphoma which I am currently being treated for as well and currently just entered my 13th year of treatments, starting back in 2009.

For half those 6 years, my infusions were given to me by accessing my veins in either the right or left arm until one vein accessing hurt like hell, so I decided to have a port inserted on the right side of my chest.  It is a dual port so that the actual port will last longer or can still be used if one side goes bad.

So, every 4 weeks, I get my OPDIVO and every other month on the day that I get my OPDIVO, I see my Oncologist just to see how I am doing.  I take that opportunity to talk about any side effects that I think have been lingering an especially long time, or if I am experiencing something that I should not be experiencing...  like constant sinus infections.

Because of on-going sinus infections and continued anemia and a low immune system and low platelet count, my Oncologist decided to put me on monthly IVIG infusions.  But today, it is just an OPDIVO infusion and I can go.

I start about about 8:00-8:30 am and since the infusion only last 30 minutes, I am usually out by 9:00 am at the latest and back home by 10:00 am just in time for a late breakfast or brunch of perhaps an omelet and/or grits along with an English Muffin.

We get very used to our routines.

Staying Stable

My IVIG infusion will give me a boost for about 3 weeks before it starts to wear off...  so, what does that mean exactly?

For me,

• I sleep better
• My appetite is suppressed
• My energy level is high
• My fatigue lessens
• an end of sinus infections
• I am more active

My Oncologist wants me to receive IVIG infusions every month instead of every other month which would result in me feeling pretty darn good all the time.  And, if one feels good then one is also emotionally healthy as well which then leads to having good psychological health.   This is important, at least for me because having Lymphoma and Melanoma simultaneously means that at some point-in-time there is always the possibility that either one of these cancers or both could turn AGGRESSIVE at any time putting me in a critical health situation and threaten my life.

This Week's Medical Responsibilities

Monday and Tuesday are the only two days where I do not have any medical obligations aside from the weekend.  On Wednesday, I get my teeth cleaned which is covered by my dental insurance program and usually only lasts about 30 minutes, and I do get seen by the dentist for 30 seconds or so to simply verify the findings of the dental assistant. 

Thursday is my long anticipated SEOND COVID VACCINE shot and while the actual shot takes 30 seconds, I have to wait in my car for about 30 minutes in line and there is another 15 minute wait to make sure there are no problems with the shot.

Friday...  brings me in contact with my second long awaited IVIG infusion where my body is loaded up with antibodies from about 30,000 to 50,000 other individuals.  I am receiving this infusion because of my low immune system which has in turn caused me to have constant sinus infections and nose bleeds.  A couple of years ago, I was receiving this infusion monthly, but due to a shortage, I was eliminated from the schedule since my need was not critical.

A year later, my Oncologist put me back on the schedule for IVIG but every other month...  and, the month of the infusion, everything inside my body was cleared up but in the off month, everything that it had corrected returned.  I shared this with my Oncologist and he was going to write orders for me to receive the infusion every month.

I will find out if those orders went through this Friday.

The Day After

Yesterday, I had my 42nd Opdivo infusion which means I have been receiving Opdivo for 3.5 years now and while my body seems to be tolerating it pretty well, I am still experiencing cumulative symptoms of night sweats, fatigue, and loss of appetite.

I also met with my Oncologist who was not that concerned about a lesion on my liver but since I was scheduled for a CT scan, he would pay close attention to what it showed for the liver.  He was also not that concerned with my 6 weeks of night sweats every night because there was so many issues that could be causing that to happen to my body...  again, he would be mindful of my sweating in the future.

He was a little concerned that the month after my IVIG infusion, my sinus problems were returning so he was going to write new orders for me to receive IVIG every month...  Not only would this help my sinuses but when I was receiving IVIG every month, I actually felt wonderful both mentally and physically.

Other than these comments he was pleased with all my test results and was going to continue with all my treatment like before with no changes.

IVIG Brings Me Back To Life

Yesterday, I had my IVIG infusion.  It lasts about 2 hours including pre-meds and my Oncologist has arranged every other month for these infusions instead of monthly because there is still a shortage and my needs are not critical.

AND YET...

one day after the infusion, I feel wonderful...

My sinuses have cleared up to the point where there is no congestion.

My loss of appetite has returned.

My sense of clarity and purpose has returned.

My feelings of lethargy and fatigue has disappeared.

IN SHORT...

I feel really, really good.

UNFORTUNATELY...

it will not last more than a couple of weeks before the IVIG infusion benefits wear off and I will return to the way I was feeling until the middle of MARCH when I have my next infusion...   BUT, that is actually good because at the end of March, the college class I will be teaching at night begins.

SO...

all in all, it is still a good day.

The Return of IVIG

Intravenous Immunoglobulin (IVIG) is a therapy treatment for patients with antibody deficiencies. It is prepared from a pool of immunoglobulins (antibodies) from the plasma of thousands of healthy donors. Immunoglobulins are made by the immune system of healthy people for the purpose of fighting infections. While IVIG is derived from plasma (a blood product), it is so purified that the chances of contracting a blood-borne infection are extremely low.

Unlike many of the medications prescribed by rheumatologists, IVIG does not increase the risk for infection. IVIG works in different ways to prevent the body from attacking itself and to decrease several types of inflammation in the body.

IVIG is given as an intravenous infusion (through the vein in the arm), which takes several hours to complete. Frequency of infusions vary according to the patient’s need. It may be given as a one-time infusion (such as for Kawasaki’s disease). For other diseases, it may be given from anywhere between one to five days on a monthly basis. Frequency and duration of infusions depend on the underlying disease and the clinical course. IVIG can take several weeks to fully take effect.

                                                               

Yesterday, during my visit with my Oncologist and because I was experiencing frequent infections, he decided to return me to receiving IVIG every other month. I will be meeting with the Oncologist every month at least during these first few months to make sure that I am tolerating IVIG.

Potential Side Effects
The majority of people do well with IVIG, experiencing only minor side effects. IVIG may cause infusion reactions, including fevers, chills, flushing, rash, muscle aches, and nausea. Headaches are also relatively common. These are generally not severe and improve with analgesics and antihistamines. Additionally, because the medication has a large volume, it may worsen heart failure and may cause the blood pressure to be elevated temporarily. IVIG also increases the risk for blood clots slightly when given in high doses.