How can patients get ready for a Biologic infusion?
Doreen asked how to prepare for her upcoming Rituxan infusion. Here are some general tips that might help with any kind of Biologic infusion. As usual, I’ve learned most of these from other patients and from the effective teacher called experience. The orange Rituxan blanket was a gift to me from my lovely friend Nancy who helped me through my infusions when I was in a clinical trial. It’s a symbol for me to never give up.
As soon as you and your doctor decide you’ll go on a Biologic
1. Check immunizations. If you have a few weeks, ask your doctors about whether any vaccinations would be a good idea.
2. TB test. Whether it’s a skin test, lung x-ray, or blood test, be sure you’ve had a recent TB test. This is recommended in most areas, but some studies show it’s not always done. Latent TB can be more easily activated when on Biologics and may need to be addressed ahead of time.
3. Patient support programs. Look up the manufacturer’s website or phone number for patients to ask questions. You’ll know how to contact them if you have questions later and they may help you feel better prepared.
4. Payment assistance.Pharmaceutical companies have “copay cards” to help patients with the cost of medications. Ask your doctor to help you participate and bring them paperwork from the company, if needed.
5. Address anxiety. Even if you’ve had other Biologics or other infusions before, if you are concerned that anxiety might be a problem during the infusion, talk to your doctor. Together you can decide whether you might benefit from some medication to make you more comfortable on infusion day. Strange, but true: when I was the first patient in their clinical trial, even my nurse took a Xanax!
Approaching infusion day
6. Ask questions. Address any concerns with your doctor ahead of time to feel as prepared as possible on infusion day. They should be able to explain to you the protocol for the drug you are receiving, such as which pre-medications are used and at what rate they are administered.
7. Drink up. The day before the infusion, drink plenty of water to be sure you’re well hydrated during the infusion. This is believed to make IV’s easier to insert and reduce infusion reactions. Maybe you can also buy a bottle of your favorite water or juice to bring with you to the infusion.
8. Rest. Getting a good night’s rest the night before will help you feel less anxious and better able to tolerate the long day you might have in the infusion room.
9. Just in case. Go over any infusion reaction procedures with the nurses who will manage the infusion. Reactions are rare, but you may be more relaxed knowing they are prepared.
On infusion day
10. Eat a healthy breakfast. Unless your nurse asks you to fast for some reason, eat a healthy balanced meal to keep your blood sugar steady during the infusion.
11. Invite a friend. My first Orencia infusion, I called an infusion party, bringing my best friend and my daughter for support. We even went to lunch afterward.
12. Comfy clothes. Wear something soft and easy to move in. Sitting in a chair can make you stiff enough – you don’t need clothes to restrict you. Realize you may also need to use the restroom with only one had free, after all that water you drank with the IV!
13. Lap blanket. Medical facilities can be cold and some people feel an IV gives them a chill.
14. Bring small snacks. Infusions can last long enough that you’ll get hungry. And eating something will help the time pass quicker too.
15. Fun diversions. Bring a book, magazine, or other activity you can do on your lap.
16. Laptop, iPad, or phone. It can be very helpful to communicate with supportive people via texting, Twitter, or Facebook.
17. Driver. It’s impossible to predict how you’ll respond to an infusion or whatever pre-medications you receive such as Benadryl / diphenhydramine, so you may not want to drive home, at least the first time.
18. Speak up. If at any time, you are concerned about your well being, uncomfortable with what’s happening, or worried about anything, speak up. Even wonderful nurses cannot read your mind or may make mistakes, so speak up if you need to.
After the infusion
19. More rest. Sometimes the infusion may leave you tired or with a headache the following day. Some have side effects from pre-medications such as puffiness or flushing. However, some actually feel extra energy as an effect of intravenous steroid pre-meds.
20. Realistic expectations. A biologic does not take usually effect immediately. As I often remind patients, expect the best possible result, but realize Biologics are not magical and instantaneous improvement is rare.
21. Tell your doctor how you feel. Ask what number you can call with any concerns after the infusion and contact a medical professional if you have any symptoms that worry you.
Hopefully these suggestions and those on the comments page will help you be prepared for an infusion and allow you to be more relaxed. Of course no article online is a substitute for the individualized medical advice we all need. Disclaimer.
I’ll bet you have more ideas or tips to help others! Let them know your ideas using the comment box below.
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