Rituxan next???

Tuesday i had another appointment, i was at 58. My hema had been pushing for pred again. After i told him about my last 4 days of dex (couldnt walk and fell a few times from joint pain) He pushed for it again, so im on 120 mg again. He seems to be against nplate and promacta, but talks about doing rituxan or spelenctomy next. Keeping my spleen for awhile yet so thats out. I was diagnosed last December, is it too soon for rituxan or should ask to try promacta, but im not sure if it would work since my count is responsive to pred and dex (high doses, but does work). I havent been over 100 since my last ivig (6+ months ago) So far ive responded with everything, but its the black box warning thats holding me back. I know its not that big of a deal, but its got my parents more worried. I have a cbc next week and appt the week after. Pred isnt as effective as dex so my guess is ill be 30-60 range. Im going to try rituxan when my hema gets tired of me complaining about steroids. Is there any time i should take off work. I work nights and i understand it takes a few hours, would it work to take a night off for the first dose just to take it easy? Thanks in advance.

I'm not going to tell you what you should do but I just want to say that steroids working well bears no connection to whether Promacta or Nplate will work. Steroids work well for me too and so does Nplate.

If you do Rituxan, the pre-meds will cause you to be out of it for a while. I had my infusions during the day, got a good nights sleep, and worked the following day. I wouldn't work a whole night after the treatment.

I work nights also, Sun-Thr. I scheduled my treatments on Friday mornings so I had all weekend to relax. The pre-treatments are what knock a person out. I had a reaction during the first treatment of my second round of Rituxan. Treatment was stopped, meds for reaction were given and treatment was started an hour later at a slower rate. I think you will do just fine. The first treatment for me took all day as it was started slow to see how I would tollerate it. It really depends on how you feel afterwards and how long the treatment lasts. I would consider taking the night off after the treatment. Depending on your job, it could be a safety issue for you.
Good Luck!!!

I work 12's mon-friday, i could always take a friday night off and take the weekend slow. What sort of reactions do you get?

Some people get a reaction during the infusion...scratchy throat, coughing, difficulty breathing, etc. They slow the drip and add more meds to counteract the reaction. Most are fine afterwards, just tired.

Since reactions are most common to the first infusion, and then no reaction to later infusions, you might want to just plan to take off that first time.
Erica

My first round I had a scratchy throat which started a cough but a piece of candy took care of that. The first round took 7 hours for me the rest about 4-5 hours.

Cgerbs wrote: I work 12's mon-friday, i could always take a friday night off and take the weekend slow. What sort of reactions do you get?

I think that is a good idea!! 12's are a long shift, especially at night and working a 12hr after a treatment may not be a good idea. I had the same reaction as already mentioned. Expect approximately 8 hrs for the first treatment to see how you tolerate it. The next few may take only 4-5hrs.

Good Luck!!!

Ill be giving it a try once i see the doc again. Thanks everybody.