First Dara infusion

Doug had the diode laser surgery on his left eye on 1-29-19. The procedure went well but it will be some time before we know results. After surgery, the eye pressure, and thus vision, can fluctuate for several weeks. So he still is not driving and we don't know if he will ever be able to see well enough to drive. 

on 1-31-19 Doug had his first daratumumab infusion at HRRMC. Dara is a targeted therapy. a monoclonal antibody directed against CD38, a molecule present on myeloma cells. He also takes Revlimid pills after the infusion, and dexamethasone tablets the day after. 

It was a marathon day. We pulled into the parking lot at 8:00 am and drove out at 7:00 pm.  

Several things have to happen before the infusion can start. First the nurse accesses the port using sterile technique. Then blood is drawn and sent to the in-hospital lab for testing. Sometimes the blood values drop low enough to temporarily halt treatment.  When results come back and the oncologist approves, the order to proceed is sent to the lab so they can prepare the solution. Also after the oncologist approves,  the pre-infusion meds are given, to lessen side effects. Doug got benadryl, dexamethasone and tylenol in his IV. The benadryl made him nice and relaxed and somewhat drowsy. One hour has to elapse after the pre-meds before the infusion can begin. So the first two hours were spent getting ready. 

Doug did have a reaction to the Dara, which happens to 50% of patients during the first infusion. They get a sort of allergic reaction that causes the upper airway to swell; if not treated quickly the airway can close down. 

Doug's nurse was watching him pretty closely without being overbearing. 

She told Doug what to watch for, so when he felt a little sore throat, he told her. She immediately stopped the dara infusion (temporarily), started some rescue drugs (solumedrol and pepcid) into the IV and called for the doctor and a respiratory therapist who came and gave him a bronchodilator (albuterol) with an inhaler. He had to breathe into a bag for five minutes. Because the nurse caught it quickly, there was no sense of panic, just teamwork and efficiency. Doug stayed calm. This happened about two hours into the infusion. 

Once all that was done and he was ok, the infusion was resumed at a slower rate.

A very long day! But at least we were home 30 minutes after leaving the hospital. I did have to drive in the dark - I just went slowly and prayed. We both were very tired. 

He will get the infusions once a week for two months, then every other week for another two months, then once a month, and continue once a month. He will continue on this drug unless he can't tolerate it, or until it no longer works. 

The infusion center here is amazing for a regional hospital. We know a few of the nurses from past infusions. They are all excellent; compassionate, cheerful and competent. We are confident in the care Doug is getting, and so thankful to receive this level of care close to home. 

Now hopefully a few days of rest. Neither of us is sleeping very well. 

Today's verse:

Fix your thoughts on what is true and honorable and right. Think about things that are pure and lovely and admirable. Think about things that are excellent and worthy of praise. 

Philippians 4:8