Oh Goodness...you have been through the ringer with Care Mark.
I am so sorry for your frustration.

I do not have personal experience with infusion centers, but here is what I do know about Infusion nurses. Putting in IV's is not a standard part of Nursing School. It is additional training that a nurse can take special training for later. So, given that you are going to an 'Infusion center' I would hope that every nurse went through special training to learn how to put in an IV. That is how is SHOULD be...I'm doubting Care Mark at this point, but let's just assume you are really going to an Infusion center.

I have a home health nurse who does my IVIG...She also does IV work for people with Iron Deficiencies, hemophiliacs, and I forget what else, but I know the agency just hired a nurse who was an Oncology IV nurse, so soon they will all be trained in administering IV Cancer Treatments.

So, assuming you are going to an Infusion Center, an experienced IV nurse should be able to put in a line for your IVIG.

Make sure you have orders sent from your Immunologist for any pre-meds, or bring your own Benadryl, Tylenol, etc...bring your own fluids.

ABSOLUTELY make sure your Immuno sends orders with your rate of Infusion and have a hard copy in your hands when you get there. Some Infusion centers are known for trying to speed things up to free up beds...do not let this happen. If you can, ask your Immuno for pre and post op IV fluids, just to extend the time and to help your body dilute and process the IgG.

Since you have had reactions in the past, ask your Immuno to lower your rate of Infusion- if it was 4 hours, ask him to write the orders for 5, and have that hard copy.

if a nurse comes to your IV pole ask what's up...is she titrating? Bumping up the rate? If yes, pull out the hard copy of your orders, and ask if what she is doing is increasing your rate of infusion. If so, ask her to stop and please call your Immuno before she goes any further. You have side effects and there is a reason your Immuno wrote specific orders.

Document everything- I am hoping you have a good experience, but if this Infusion center is sub-standard and they do not follow your Dr's orders, that may be your ticket back to the hospital and out of this silly brown bag stuff.

I know this post is long, but if the nurses are less than nice to you, I want to share how to make friends with them.
First, tell the nurse you are cold and ask for a blanket.
Then in ten minutes tell her you are hot, and could she please take the blanket and bring you some ice chips.
Then in ten more minutes apologize and tell the nurse, you are shivering-must be the ice, and could you please have a blanket again?

That will win the heart of any nurse who does not treat you with the respect and compassion you deserve :)

Best, LuLu

Hey! Okay, just to alleviate any extra worry....your nurse will be trained in IVs!! I can assure you that they did not graduate before sticking a ton of innocent patients:) In my opinion it is not a HUGE deal that they do not deal with a lot of IVIG. Your doctor will write orders for your drug, flow rate, pre meds, fluids, emergency drugs, etc. They are required to follow that. Our infusion pumps work the same as everyone else's, and there is no special science to hooking up our meds. I am sure you are educated on the side effects, and know what it feels like to have a reaction. Inform them about EVERYTHING you are experiencing so they can monitor you properly. If an immune deficient patient crashes, it is dealt with the same as when a cancer patient crashes. The only difference in your infusion is the medication. I am sure you will be fine. And I wouldn't be discouraged if they ask you questions. It is good when they ask about things they aren't familiar with. But all in all....they should be capable of safely administering your IVIG. Your doctor is the one that handles the nitty gritty, and they follow his lead. Glad they got your situation worked out, and I hope your infusion is smooth sailing!

Thanks for the replies. I feel better I do believe it will be a good experience. I'm used to telling the nurses when and how much to increase my rate based on how I'm feeling. I know when my body starts reacting and the highest rate I can tolerate... I'd better call the doc tomorrow to ensure this won't be an issue! good tips! THANK YOU!

My doctor put a "max" rate on the orders. That way they cannot exceed a certain limit, and it is never moved to a rate that I cannot tolerate. They start the infusion extremely slow, and move the rate up to my max over the first hour. When I start reacting, they stop my infusion completely and then slowly increase it again. If I am having a lot of issues that day they can run it slower than my max rate, but they can never exceed. It gives them wiggle room, while ensuring my safety. My infusion runs 12 hours without interruptions and consistently maintaining the highest rate so it can be a painfully long day but I react pretty severely so it is comforting to have my orders placed this way. It is all about communication. You know better than anyone how you are tolerating treatment. Speak up if you are feeling off! Let us know how it goes!

Count,

If it is an oncology clinic, I wouldn't be too worried. The chances are pretty high that they have given IVIG. If they haven't given this particular product, they have certainly given blood products including packed red blood cells, platelets, albumin, and some pretty heavy duty chemotherapies.

They should be well versed in treating any reactions that you may possibly experience. Plus, the nurses will have plenty of experience in titrating medications in case you need this performed as this is needed in many chemotherapies.

Personally, I would feel comfortable receiving this medication in an oncology clinic.

Good health!
TheWino

I get mine at my oncologist/hemo doc office have been since 2007. I would call and ask them if they have experience with igg also what to expect.

instead of relying on them to get the docs orders I would go by doc office and have a hardcopy in hand may save lots of time. I often find paperwork doesn't always make it to where it should be... better safe than sorry esp since you have had problems with igg reactions