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Getting Ready for Infusion Day

If you are anything like me, you often take one day at a time. This is great for most situations; but when an event is on the horizon that would benefit from a little advance planning, it is important to take a look at the calendar and work backwards.

This Thursday, I have a Rituxan infusion scheduled. As this will begin my 10th round of treatment, the actual infusion no longer poses much concern for me. I know what to expect, although careful planning will make the day go more smoothly.

Here are my top 10 personal recommendations for infusion day and the week leading up it.

  • Plan to get a ride.
    Due to previous infusion reactions, my rheumatologist now prescribes two types of antihistamines and a little extra steroids to reduce the chance of having a reaction. This combination will often make me very groggy at some point during the day and not entirely safe to drive. Ask a friend or loved one to drop you off and pick you up.
  • Dress comfortably
    The standard routine for a Rituxan infusion requires that the medication be delivered over several hours. Since I’ll be sleepy (see previous note), brief naps will most definitely be involved and it is important to be comfortable. It is also important to wear clothing which is easy to unfasten quickly, particularly when you may have an IV attached to your dominant hand or arm, for those hurried bathroom runs.
  • Bring food.
    Due to those previous infusion reactions, we keep the infusion pump flowing at a slower rate rather than increasing the rate every 30 minutes as per standard Rituxan protocol. As a result, we will start extra early and know that the day will be predictably long. This means that you will be sitting in that infusion chair during mealtime, and trust me, you will get hungry.
  • Bring connectivity and entertainment.
    If your infusion center has wi-fi internet access, thank them! Bring your computer, tablet, or phone to connect with your friends online. Share your experiences throughout the day on social media. The support you get will be very encouraging. We never need to feel alone. You can also play games, check email, and catch up on reading your favorite websites and blogs.
  • Shower and shampoo.
    For those who have not had previous Rituxan infusions before, know that it can be helpful to thoroughly clean up in advance of the infusion. Why? Because an early sign of an infusion reaction may be itchiness. If your head is feeling itchy because you needed to shower or shampoo, it can be difficult to tell the difference between that type of itch and one that signals an impending need for intervention.
  • Eat breakfast and drink lots of water
    Although you’ll be bringing food (see previous recommendation), it may be helpful to start your day with something on the stomach. This may also help you to delay eating your lunch or snacks at least until midday so that you don’t run out of food, or eat absolutely everything you brought. Steroids, even when given as part of a larger treatment protocol, can still make you feel very hungry.
  • Go shopping.
    Since you will be bringing lunch and/or snacks, it will be helpful to have some wonderfully fresh fruit on hand. My favorite things to pack include grapes, pear, apple, carrots, yogurt, low calorie gatorade-type drink, water, and a good-sized sandwich with high-quality protein. Go shopping at least the day before. You can even wash everything and prepare your lunch box the night before so that it’s easier to get out of the house in the morning.
  • Do laundry.
    If there is something you’d like to wear on infusion day, make sure that it is clean; it’ll make you feel more comfortable. It’s also helpful to have clean clothes for the days after the infusion because you might be tired and not feel like completing chores around the house immediately following treatment.
  • Drink water, lots of water.
    I know that I already suggested drinking water on the morning of your infusion; but if you have difficult veins like I do, it is absolutely necessary that you begin tanking up on water for several days before your infusion. Seriously, this will help and if you’re not going to the bathroom an extra amount, you probably still aren’t drinking enough to make a difference.
  • Cancel activities.
    If you work in the evenings like I do as a private music teacher, consider canceling or rescheduling your planned activities for the evening following your infusion. Sitting most of the day in a chair with limited options for positioning, regardless of how comfortable that chair may be, can be surprisingly exhausting. So plan ahead and make arrangements to take care of business or socialize on a different day. This is a time to take care of yourself.

Hopefully these tips will help you the next time you prepare for an infusion. Please leave a comment and share your own tips in the comments section below.

Be well, my friends.
Lisa

 

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Veda Logan
    4 years ago

    I noticed that you said that the actual infusion no longer concerns you, but sometimes unusual things happen. I had been on Rituxan for 2 years and then I had an infusion reaction! It was awful – I turned red all over, my chest hurt and my heart started pounding!! They stopped it immediately and gave me a large dose of steroids and benadryl. Until that time, Rituxan had been providing alot of relief for the RA symptoms. I hope all goes well for you.

  • Lisa Emrich author
    4 years ago

    Hi Veda,

    I know exactly what you are talking about. Similar symptoms happened for me. I was also itchy, my tongue swelled up, and I started having trouble breathing.

    I had a tremendous infusion reaction during my first infusion, and my second infusion, and my third infusion, and several more times before we finally figured out what combination of extra pre-meds (extra solumedrol, double benadryl, zyrtec, and tylenol), plus a very slow drip rate for the Rituxan portion (given over 6 hours), reduced the occurrence of reactions. I haven’t had a reaction in two years now.

    Rituxan has been great in reducing MS and RA symptoms. I hope that it continues to work well for you, too!!

    Lisa

  • Rose de Kook
    4 years ago

    Thanx for your thoughts on this. I have been on Actemera infusion 8 mths now. Takes 1.5hrs to go through. I’ve tried mornings but prefer afternoons as I often feel like I must go to work before or after. Now I take the day off. My GP also recommends that I take the day off when I have her appointment. Fatigue is my hardest thing that and pain. My tolerance levels are just not that good any more

  • Lisa Emrich author
    4 years ago

    Hi Rose,

    I hope that Actemra works for you. It’s hard when you want to get things done and need to simply take it easy. I hope that your fatigue and pain diminish.

    Be well,
    Lisa

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