It wasn't the INFUSION PROVIDER who made the response.

It was the Visiting Nurse Service person.

I just took Alan's temperature (he had taken two acetominiphen as soon as he came home). His head felt hot. He has a fever of 101.

Now could this be from the IVIG or does this mean he has an infection?

Oh, I just checked the bag that she transferred the gamma into. The label on the bag says: 0.9% Sodium Chloride Injection USP 500 mL. She emptied this completely and then transferred the gamma.

He went to the doctor's office this morning, he told the guy who drew the blood all about what happened. They drew his blood.

Do I now call back Frank (the guy who took his blood and tell him that Alan has a fever of 101).

I really am trying not to panic here.

Melody

i would call frank.

maybe they can test his blood for other infections.

i know this is scarey melody. you are doing everything you can. all the right things.

lots of fluids for rocky. if he did get something...his body is fighting it. that is a good thing.

A slight rise to 101 is not panic time, Mel.
It is be observant and watch time.
Yer doin' all ya can. If he spikes high overnight
(103-104) go to the ER - don't wait for tomorrow.
But that probably won't happen.
If Alan keeps a low grade fever for 36-48 hours,
take him to your doc asap.
Over-cautious is not panic. Overcautious is concern.

We have no way to go the ER. We have no family and we are alone.

I just took it again and it's still 101. I gave him a big glass of water and I'm making him Tea.

Can this be from the IVIG infusion (as a side effect), or does this absolutely have to be from the hole in the bag?

I just want to get all the information.

Melody

The 'don't talk to anyone about this..' makes me concerned. 'Not approve of this being done this way' Also makes me concerned about how they have infused and handled the IVIG.
Do call Frank and be sure Dr Fred gets updates.
Dr Fred tho isn't the doctor who prescribed the IVIG, is he?
If it is, Dr Fred will be on alert.
IF the prescribing doc isn't Dr Fred, CALL THAT DOC with the same info you've given to Dr Fred. The prescribing DOC should be totally up-to-date on any issues that can go wrong as that is the doc who will be the one with primary responsibility along with the home service.
Flu-like symptoms [headache, lo fever, diarhea, and sometimes crampiness in the legs, rashes and vomiting] are often side effects of infusions. These are usually taken care of by pre-meds of tylenol, benedryl or both. Lots of tylenol or the like for headaches afterwards is the normal. They usually go away in 2-3 days.
These often are caused because the infusion rate was given too fast.
I can handle a lot more of the IVIG. I get mine in under 3 hours, but it took a long time to get the 'timing' of the infusion rates till it's just perfect-for ME.
You are trying to do all the right things. One thing you will NOT do is give the home service that BAG! Got that?
I'll check in for the updates I know you will be giving us - I'm hoping it's nothing and probably isn't anything. Should that change, it will probably change very fast - so be warned.

and patience for now - good person! - j

Which brand of IVIG did he receive - I'll post the full 'prescribing info' as soon as I know -

Thank god you wrote what you wrote, (about flu like symptoms, fever) might be the reason he has the fever. He has never had a 3 hour infusion before.

It took her till after 5:30 to start the infusion and she left around 8:45 p.m. (we were watching American Idol) and the bag was empty.

Now you ask for the brand.
Here's the information:
---------------------------------------------------------------------

OCTAGAM 5% 30 Gms (600 ml) (mix)
Infuse Octagam 5% 30Gms (500ml) IV over 4 hours daily x 2 days every month as directed by MD.

Pre-medicate 30 minutes prior to IVIG with Diphenydramine 25mg orally. Acetaminophen 650 mg orally.
Storage - Keep Refrigerated
Discard After 5/028/07
----------------------------------------------------------------------

Question: every nurse said "he is tolerating this vey well". Now when they say Tolerating very well, are they referring to "he's not going into shock", or "his blood pressure is not dropping", etc. etc.

Or is the fact that he got a fever the next day "not tolerating it very well"???

I just told him what Dahlek said about side effects of IVIG being flu like symptoms and fever, etc. and how the rate of infusion can cause these things and Alan said "I knew it, she stepped up the rate of infusion".

Now I have no idea if he's contaminated or what. I guess we'll wait and see about that.

What do I have to look for and how long??? A few days I would imagine.

This never happened before so I guess it's the getting used to all of this.

Oh, and Dr. Fred is not the physician who prescribes the IVIG. It's the neurologist. I'll write up everything that happened and fax it over to her.

THANK GOD I CAN TYPE 145 WORDS A MINUTE!!!!!! I never typed so many posts in one day in my life ......lol

Melody

On the fever-has he had one before after receiving IVIG?

Has he felt like this before, after receiving IVIG?

It is not uncommon to get a fever, low grade after IVIG, 101 is not low grade....it isn't real high---it is just kind of on the borderline of concern..101 in an adult is more concerning than 101 in a kid.

Just call the doc to be sure. If he had not had the bag leak I would be less concerned, with the bag leak, I am slightly more concerned...

Did you take an oral temp? What kind of thermometer did you use?

The rate of infusion yesterday, should have no consequences today.

The patient is essentially monitored at the time for a 'reaction' to antibodies from foreign donors, just like in a blood transfusion.

You see reactions, that are lifethreatening, almost immediately in transfusions....sometimes it is just to rapid of an administration rate...they just slow it down...usually this is preceeded by a severe headache or drop in BP.

A reaction, is not a bad thing in IVIG, it is just the body's response to this ton of foreign antibodies. It can be totally normal.

Now the detective work comes in as to whether or not he acquired an infection as opposed to having a normal reaction to IVIG. Some folks don't get fevers, I never had one...no problems what so ever, some folks do.

Blood pressure drops are indicative of a blood product reaction...that is why the nurse is supposed to monitor that while transfusing.

Stop posting, take a rest. Calm down...this is all manageable...

Call your neurologist. Ask to speak with her/his nurse. Tell her what happened. Don't go taking his temp every 5 minutes....every half hour will do...parameters change constantly you just need a trend. No more than every 15 minutes, you hear??? Mel, it is going to be fine.

I have horrible ear pain for some darn reason...(I mowed two acres on my garden tractor in hurricane force winds yesterday and I don't know if that is it, but I can hardly stand it and I maxed out my pain meds...I just happen to see the neuro tomorrow...he is going to be an ENT, lol) I am trying to keep an eye on posts, then lying down, then posting, then lying down...it is always something.

He has never had a reaction (other than a mild headache) to these infusions. And he has never had a fever. And he never had a 3 hour infusion either. They were always a bit over 4 hours. In the hospital they were 6 hours.

It's been almost one hour since I took his temp and I just took it, it's 99. It's a oral thermometer. And my mother was a nurse, so I know how to read a thermometer. And it's the old fashioned kind. Not the new digital one.

I disinfect it each time I take it out of his mouth. And I shake it down before I put it in his mouth.

I'm going to call the neurologist after I finish typing this. I don't expect to get her today. Should I call Dr. Fred and tell him about the fever.

Alan went there this morning for his usual blood work but AFTER HE CAME HOME, that's when he got the temp.

He just said that compared to this morning, he does feel a bit better.

Now I know I have to watch for fever spiking tonight and I will.

I just went to the pharmacy near my house to buy some tylenol. Would you believe I had no more tylenol in my house?

I was telling the pharmacist what happened and you should have seen the look on his face when I said "she went into the kitchen, hung the top of the iv over my cabinet knobs and did a transfer from the ivig gamma bag into an empty bag that was marked Saline". His eybrows shot up and he said "she did what???" "It's supposed to be done in a hooded environment, (or something like that). I said "yeah, I know, she wasn't supposed to do this".

He said everything single thing you guys said. I told him I knew all this because I go on the neuropathy boards and everybody knows all about IVIG. He told me to immediately call his neurologist and inform her about what happened. So off I go.

Keeping fingers and toes crossed.

And we have to go to Court tomorrow. Oh brother.

Melody

a muffin will make him feel better. you to melody.

ya know..this thread is going to help others. a good lesson for all to learn.

i'm sorry you and alan are dealing with this. but if your gut hadn't told you something was wrong with the way things were handled... you wouldn't have posted.