Here you go:
http://www.octapharma.com/USA/docume...rch%202007.pdf

Pages 7 thru 9 are what you should know... - j

My god, I should have been a nurse like my mother. She went to nursing school in Florida at the age of 55. She became a licensed practical nurse and worked for many years in senior citizen nursing facilities and rehabs.

I HAD to be an executive secretary!!!

oh well. At least I can type and speak a few languages.

Anyway, he's sleeping. He drank LOTS of fluids.

So we shall see. I did indeed put a call to his neurologist but its rather late.

God, I hope we don't have to go to the emergency room.

And we have a court date tomorrow. He is determined to go!!

And he thinks he's going to his job as a night watchman on friday at midnight.

Oh yeah, like that's gonna happen!!!!!

Melody

Assuming he shows no further signs of debilitation (which we all hope for), and everything goes well for you two tomorrow (which we also hope for). . .

Hi Mel

His temp might go down, and he might be just fine.

Court is stressful. I hope tomorrow is the end of this for you.

He might even be able to go to work on Friday if this blows over, if not, I am sure they can cut him some slack for being sick one day.

Don't stress to much...I am just very displeased with the infusion nurses and their chain of command. Sterile handling of IV fluids, IM injections, Sub Q injections, intradermals, all needle, tube type things with the exception of straight caths that some quads do for themselves are sterile...even the straight caths are kept really clean. The only tubes we don't fret about being sterile are GI tubes, because the intestinal system already is colonized with bacteria, usually helpful bacteria. We exist in a truce with bacteria, they help us and we help them, except for the 'insurgent' bacteria...the stuff we do not want.

All organisms, even the friendly stuff, can get the better of us..who amongst us has not had yeast (candida or monililia)?

I think your profession choice was a good one. You are highly organized and can probably type at the speed of light. Being a nurse might have driven you over the edge with worry about your patients. Given your devotion to Alan, if you did that with all your patients, you would be exhausted beyond belief.

I am just very irritated that the cardinal rules of nursing science were broken. This is not high tech, but the very basics, ABCs of good nursing care. I understand the cost of the medicine, but that does not justify risking an organism getting into a patient's bloodstream. Not counting the patient's suffering and risk, it is not cost effective if the patient gets sepsis.

People do not understand that health care, despite being labelled 'non-profit' is not really non-profit. Nurses bear a huge responsibility, and their salaries are non commensurate with their responsibility, as I PM'd you on what we need to know.

A nurse that administers the wrong medication or wrong dose is held responsible, regardless if the doctor ordered it and the pharmacist prepared it. It doesn't seem fair, but we are the last safety check before it ends up in your body. With an ever increasing amount of pharmaceuticals the job is becoming increasingly more difficult, and medication errors are rising. Systems have not caught up with the problem yet.

Conditions called 'iatrogenic' or treatment caused problems are growing. As people learn about meds, treatments, procedures, they all demand more of the doctors to do them. Some doctors also see $$ in innovative procedures, many of them unproven by time as of yet. When a doc really lays out the pros and cons, and sometimes suggests we do nothing for a while, people get mad and go elsewhere, because they want a cure....and that is not always the best...

Consider that hospitals have many antibiotic resistant 'germs' I think msrd mentioned. As a home care nurse, we cared for MRSA patients at home, and then had to go to other patient's homes. Of course there are precautions we take to avoid getting MRSA or spreading it. There are several strains of antibiotic resistant bacteria. People need to realize that medicine is some science, some art, and some luck.

I don't know why Alan is receiving IVIG. Like I said it can be used to boost immune systems or lower immune response....it is a modulator that helps patients with diseases where an immune process is thought to be the etiology. IVIG is one of the safer blood products, as it is 'washed and filtered' to prevent most common and even uncommon diseases from being spread. I just recently became concerned about Prion diseases, but found that they filtered IVIG for Prion diseases and felt the risk was low.

IVIG is still a form of a blood transfusion in a way.

Hi Mel

His temp might go down, and he might be just fine.

Court is stressful. I hope tomorrow is the end of this for you.

He might even be able to go to work on Friday if this blows over, if not, I am sure they can cut him some slack for being sick one day.

Don't stress to much...I am just very displeased with the infusion nurses and their chain of command. Sterile handling of IV fluids, IM injections, Sub Q injections, intradermals, all needle, tube type things with the exception of straight caths that some quads do for themselves are sterile...even the straight caths are kept really clean. The only tubes we don't fret about being sterile are GI tubes, because the intestinal system already is colonized with bacteria, usually helpful bacteria. We exist in a truce with bacteria, they help us and we help them, except for the 'insurgent' bacteria...the stuff we do not want.

All organisms, even the friendly stuff, can get the better of us..who amongst us has not had yeast (candida or monililia)?

I think your profession choice was a good one. You are highly organized and can probably type at the speed of light. Being a nurse might have driven you over the edge with worry about your patients. Given your devotion to Alan, if you did that with all your patients, you would be exhausted beyond belief.

I am just very irritated that the cardinal rules of nursing science were broken. This is not high tech, but the very basics, ABCs of good nursing care. I understand the cost of the medicine, but that does not justify risking an organism getting into a patient's bloodstream. Not counting the patient's suffering and risk, it is not cost effective if the patient gets sepsis.

People do not understand that health care, despite being labelled 'non-profit' is not really non-profit. Nurses bear a huge responsibility, and their salaries are non commensurate with their responsibility, as I PM'd you on what we need to know.

A nurse that administers the wrong medication or wrong dose is held responsible, regardless if the doctor ordered it and the pharmacist prepared it. It doesn't seem fair, but we are the last safety check before it ends up in your body. With an ever increasing amount of pharmaceuticals the job is becoming increasingly more difficult, and medication errors are rising. Systems have not caught up with the problem yet.

Conditions called 'iatrogenic' or treatment caused problems are growing. As people learn about meds, treatments, procedures, they all demand more of the doctors to do them. Some doctors also see $$ in innovative procedures, many of them unproven by time as of yet. When a doc really lays out the pros and cons, and sometimes suggests we do nothing for a while, people get mad and go elsewhere, because they want a cure....and that is not always the best...

Consider that hospitals have many antibiotic resistant 'germs' I think msrd mentioned. As a home care nurse, we cared for MRSA patients at home, and then had to go to other patient's homes. Of course there are precautions we take to avoid getting MRSA or spreading it. There are several strains of antibiotic resistant bacteria. People need to realize that medicine is some science, some art, and some luck.

I don't know why Alan is receiving IVIG. Like I said it can be used to boost immune systems or lower immune response....it is a modulator that helps patients with diseases where an immune process is thought to be the etiology. IVIG is one of the safer blood products, as it is 'washed and filtered' to prevent most common and even uncommon diseases from being spread. I just recently became concerned about Prion diseases, but found that they filtered IVIG for Prion diseases and felt the risk was low.

IVIG is still a form of a blood transfusion in a way.

Alan is getting IVIG because they found protein in his spinal tap, and his neuro thinks he has CIDP, so he's a candidate for IVIG.

Just took his temp and it's NORMAL.

Now I have no idea if it will go up tonight, because I know that happens sometimes with fevers.

I guess we shall sit and watch American Idol and I shall continue to monitor him.

And I bless all of you for your constant replies and assurances.

You have no idea how much you have done for me.

OH, THE VISITING NURSE SERVICE PERSON TOLD ME TO CALL HER AT 9:30 PM. TONIGHT. I had called her this morning (before he had the fever) and she told me to call her tonight. She gave me her cell number.-


Do I call her??

Melody

If it were me, I wouldn't call her. I think they owe it to you to contact you with an apology. Just make sure you contact the doctor that ordered the IVIG.

Alan is probably going to be just fine and it is all going to be OK, however, this is not acceptable nursing practice....

I think you need to get a good night's sleep, both of you.

Oh geez, Mel. I'm so sorry this happened and that Alan had a temp. And I am sorry that the Nursing agency is handling it so poorly. (I can't believe she said not to tell anyone else --like who? Your doctor????) Anyway, I hope things start going more smoothly. Hugs to you.

Hi Dakota. Thanks for your warm wishes.

I didn't call the visiting nurse person. I simply forgot. I was watching American Idol and all those lovely singers, Bette Midler, and Smoky Robinson. I flew back in time to when I would watch the Ed Sullivan Show on Sunday nights. This American Idol was really good. But I miss Fantasia.

Anyway, Alan is still normal as apple pie and just went to sleep.

Hopefully it will be the same for tomorrow.

How do I know when he is out of the woods and I can tell myself "There was no contamination"????

Thanks,
Melody

You mention that Alan just had Octagam for his infusions this month.
Could you check back on your old notes and see what he was given during prior infusions? Did you actually get a prescription that specified a particular BRAND of IVIG? This all is important [aside from keeping Alan Happy, Healthy and WHOLE].
I had one heck of a bad experience with an infusion center switching brands and not letting anyone know well over a year ago. The label on the IG bags that were given to me [in a hospital infusion clinic, no less] at first said the proper 'brand' then changed to 'Brand or equivalent'...HEY there's no GENERIC brand X for this stuff. I kept getting mild reactions...those killer headaches akin or full brothers/sisters to migraines [not just flu-like reactions .. really blinding headaches] Turns out when I did get one serious reaction I went to these boards and 'searched the dickens out of what all there could be found on IVIG'! Boy did I learn lots, and I learned lots of problems about what is an expensive and supposedly super-regulated medication/blood product=IVIG and how it gets into US the patients!
First off-#1 IF the 'supplier', meaning the home service and/or pharmacy provides a substitute [according to gov. regs by the FDA] Your Doc has to be informed in writing within 10 days, doc then has to notify YOU of the substitution again w/in another 10 days... I found out that for a period AFTER the infusion in which I'd a reaction I had five different brands substituted during a 6 month period...no notification was ever made to either the doc or myself. No wonder I began to wonder if the stuff was working or not...I really wasn't getting the SAME stuff on a regular basis. To have a pharmacy substitue another brand is INEXCUSABLE as there are trace components in the different brands that one particular patient may not be able to tolerate and that's why all the special testing prior to OK'ing IVIG is needed ....PHARMACISTS are trained in how to safely prepare IVIG, they are not usually educated about the subtleties of the different brands/types of IVIG. What your IV nurse did, was well, quick and dirty, from a practical viewpoint. BUT it wasn't safe preparation, procedure or process by FEDERAL REGULATIONS at all. The odds of Alan getting sick or worse from what they did are small, but those Fed REGS are very very specific in all points to that of the actual administration and ARE NOT ACCEPTABLE at all!
Continued on part 2?