The Rituxan Gamble

June212009

Lately I’ve been gambling a lot.  No, not at the casino, but with my life.  My life, I’m realizing more and more, is a gamble.  I hope and I wish and I make educated decisions with risk analysis, but in the end I must simply roll the dice and see where they fall.

Recently, I took a big gamble with my health when i decided to try Rituxan for my various autoimmune diseases.  Like going all in on the last round of the night, I decided to take the chance that I might have devastating and even life threatening side effects for the chance to win big – for the chance to have more energy, to walk again, to be without pain, to be healthy again.

I’ve been fighting with my insurance company for months trying to get this extremely expensive treatment.  It’s essentially low dose chemotherapy.  It’s not cheap.  Not to mention dealing with doctor’s office mix ups with requesting the wrong medication.  Then trying to figure out where I was going to get the IV infusion.

So after months of problems, I was surprised to feel so nervous as the day of the infusion actually approached.  I was frankly terrified.  Terrified not only that I would be one of those very rare people who ends up with a horrible life altering side effect but also that I would end up exposed to Latex while there triggering a life threatening allergic reaction.

My mom and my caregiver Sarina both came with me on Wednesday to the infusion.  After considerable delay while they setup a Latex-free room for me to get the infusion, I somehow transferred from my wheelchair to the too high up exam table and tried to make myself comfortable.

The nurse was a pro and got the IV started without a problem despite my needle resistant and scar covered veins.  I brought my laptop with me and hopped onto some unsuspecting person’s unprotected wireless network and chatted with my friends online while the nurse gave me my premedication.

Things were going pretty well until shortly after she started the actual Rituxin.  I started feeling dizzy, sleepy, and was breathing shallowly.  My nails turned blue.  My mom, quick to advocate for me, requested they give me some oxygen.  Luckily that quickly made me feel much better.  My doctor popped his head in to check on me and  told me that I must be one of the lucky 3% who have breathing difficulties with the infusion.  Lucky me indeed.  The rest of the infusion went without incident.  I was worried that the breathing issues would persist after the infusion was over but fortunately a few minutes after the infusion finished my breathing returned to normal.

The next day (Thursday), however, I felt horrible.  I had the worst back pain of my life.  Right up there with double kidney infections.  I wondered if my gamble was going south.  But a quick call to the on call rheumatologist confirmed that I was having a bad reaction to the Rituxan, and he told me to bump up my dose of Prednisone significantly to calm everything down.

With the extra Prednisone and a lot of extra sleep I was feeling a lot better by yesterday.  Well enough that I took another gamble and dragged myself out of bed to see Up.  That was clearly a bad move because I feel awful again today.  But you can’t win every hand, right?

I won’t know for about two more months whether this gamble will pay off or not, and in the meantime I get to do another infusion on July 1st.  But I keep telling myself that as long as I get the big prize in the end, it will all be worth it.  Because most of life is a gamble.  You don’t know how things will turn out in the end.  There are risks to trying this Rituxan, but there are risks to not trying it as well.  So I made a choice when I decided to go ahead with the Rituxan.  I decided to roll the dice and hope that I’d like where they fell because I have my whole life ahead of me and I want it to be something worth risking for.  And well… I guess that’s a risk I decided I’m willing to take.

And with that I’m going to take another nap.

Waiting Game Woes

April142009

So I’m supposed to be starting a new treatment – Rituxin infusions, and I’ve been waiting for the insurance to approve it.  And waiting.  And waiting.  And waiting.  Waiting for TWO MONTHS now.  Calling every week or so.  Having no one call me back.  Called again today and was told the person I need to speak to will be there tomorrow only, so I have to call back then.

Do you find this shocking?  I don’t.  This is pretty much par for the course.  And as ridiculous as it is, I’m sure I’m hardly the only one going through this kind of thing.

So I wait.  I wait while my joints swell to the point it hurts to type this.  I wait while I become to tired to do even the few things I had been able to do.  I wait while my numbness gets worse.  I wait and wait and wait.

Being chronically ill is in itself a waiting game.  If its not waiting on insurance, it’s waiting on a medication to start working or a side effect to go away or for test results to come in or to get in to see a specialist.  Waiting to get better.  Waiting to start my life again.  Waiting to be productive again.  Waiting to go out again.  Waiting to have a social life again.  Waiting to look like myself again.  Waiting to feel like myself again.  Waiting.  Waiting.  Waiting.

Did I mention that I’m not a patient person?