Rituximab treatment: The unblogged story (till now)

The Infusion Related Anaphylactic Reaction

December 2008 was the first time I had done this treatment and it was also the first time it was being done in Trinidad and Tobago. That was the first time I had an anaphylactic reaction and the first time I had to spend a night in a hospital.

I was a well read, knowledgeable patient at the time having read countless medical journals, case studies and medical trials on this drug, but nothing prepared me for what was about to happen. Now short of 2 years later, it happens again... I may not have been up to date with the latest trials and reviews, but I was prepared to recognize the onset of what would become one of the worst experiences I think someone can have.

Present day:

I rushed down lunch as the docor was ready to start the infusions. I had already been given my panadol, gravol, piriton and 100cc hydrocort. A fellow patient and I began the infusion at 1:00pm. The doctor told me I need to lie down or else the flow would take forever, so I grab my donut dessert and settled onto my bed (which I think btw was made for short ppl). I munch munch on my donut, with earphones on ... munch, swallow, munch swallow, munch, swallow, munch.... swallow?

My ears felt weird? I put down the donut and handed it over to mom who asked me if I was done. I said 'yea, just now'. I took off my earphones and tried to swallow again... it's worst. Mom asks 'what happen?' ... I respond 'something's happening'. Here it was... the beginning. I closed my eyes and counted 10 seconds: 1.... 2... 3.... 4.... 5.... 6.... 7.... 8... 9.... 10 *swallow* ..... omg I cannot swallow!

I called out a nurse and mostly with gesticulations, I told her 'throat, itchy, pain, swelling, cannot swallow'. I must have been about 1 minute now since the onset of the 1st strange ear feeling. She slowed down the i.v. drip and asked if it was getting better... I didn't respond. Because I couldn't. I couldn't talk. The doctor came and ordered it to be 'dc' (discontinued) and immediately hit me up with another 100cc's of hydrocort and chlorpheniramine. At that point, 2 minutes later, I could barely breathe and my heart was racing! My on average low BP was now sky rocketing. Thankfully I had about 1 inch of my passageway open in my throat so I labored to breathe, unable to talk or swallow and unable to breathe through my nose. I stayed calm though... or at least I eventually made myself calm. Put simply, it was very scary.

They started a new bag of saline solution to flush my veins.

All we could do now was wait... I just needed O2 and time. Thankfully I had both. Things didn't get worst... I lay there for 4 hrs after, trying to breathe and stay calm. Trying to swallow felt like razor blades. Trying to talk felt like... I cannot describe. I couldn't talk. Things got better. The infusion was restarted. No more reaction. Doc and nurses checked on me constantly! They were absolutely efficient. Had I not alerted them the moment the symptoms started, my entire air passage way would have closed in and well... it would have been a scene from Grey's or House with throats being slit open and tubes being shoved down. Thank God it didn't reach to that.

5:00pm I could talk again a bit. 5:30pm 2 friends dropped in to see me, one of them brought a mocha chiller! 6:15pm, I was able to sip and swallow my chiller... and never in my entire life had I been more happy and grateful to feel something go down my throat!