PLEX, IVIG & Getting Shot in the Solar Plexus

Well my goodness, didn’t I just get shot today, shot with information… It is my intention to now pass along said information BUT in a much nicer way.

Before proceeding, may I just take a moment, as an official representative of Canada, based on my official status as an official centennial baby – to now officially wish you a Happy Canada Day.

I had an appointment with a Hematologist at Vancouver General, to discuss an Apheresis procedure – yea I didn’t know what it was either. This all came as quite a surprise to me, as none of my doctors had mentioned anything about a further referral to anyone else. After doing some research online, my understanding of Plasmapheresis is that it is an treatment to remove errant antibodies or faulty immune system platelets, it is generally used as an alternative for people who don’t tolerate the IVIG very well. Well, yes and no…

I show up at the appointment and the nurse tells me to get my shirt off and lay on the bed, instinctively I think, “hell yea” then she continues with “so I can assess you for the procedure”…. say what now? Ummm, I was told this was only going to be a consultation, the brave man said, nearly wetting himself. “Oh, I don’t know about that, I’m just here to check your veins and see if your arms are Ok or if we need to go in through your neck” …..Ummmm, I don’t like this game anymore…. OK all done, your arms are fine, the doctor will be in shortly. Thanks.

After10 minutes of me sitting in the room and working on perfecting my flop sweats – a doctor comes in, introduces himself as a neurological resident, 3rd year. He’s going to take my history, examine me and ask a bunch of questions – un-huh ,fine go ahead. So he starts off by saying I assume you know why you’re here, well docotor, actually no, I don’t – no one ever told me I was being referred here and as I understand it, the plasma exchange or Plex, is a treatment given instead of IVIG — BUT, I am already scheduled for another round of IVIG in 2 weeks. So I’m a bit confused. No problem, let me explain…..

I see here you are scheduled for a thyectomy on Friday, September 3rd – PARDON, FREAKIN ME!? — Yes sports fans, that is how I found out I am definitely a go and when for the surgery. None of my doctors told me, not the surgeon, not my GP, not my neurologist – I find out by accident from a memo some resident is carrying around on a clipboard. Still haven’t heard anything from any of my people, yes it’s a holiday tomorrow but really, when were they planning on letting me in on the secret?

Wow, truly a shotgun blast to the solar plexus…. luckily I was wearing my Kevlar – I knew it was coming but this is certainly not the way I expected to find out and I guess the randomness of it really took me by surprise. I expected to get a call to come see one of my health care folks and given a bit of time to get my big brain working on formulating some questions etc etc….

So he proceeds to tell me that yes in some circumstances Plex is given to patients in lieu of IVIG – but in my case – since I’m so darn special and unique I’ll be getting both. So what happens in Plex or Plasma exchange you ask… well I go into the hospital – 2 days in a row, get a massive IV in one arm, basically the size and diameter of your average sewar pipe and a smaller IV in the other arm. I’m then hooked up to a big machine, thereby becoming a giant circuit. In the IVIG, my immunoglobin and antibodies are replaced with donor globulin and antibodies… In Plex it’s all my own stuff, every drop I have in me is taken out, washed, the bad antibodies and plasma removed, filtered, cleaned and put back in me. Like I said 2 days, 5 to 6 hours each day for the total process. Once completed I’m supposed to be just like new…

So it’s great news, just frighteningly close. It’s going to be a very action packed 2 months… pretty remarkable to think that just a few short weeks ago it all seemed dauntingly far away, not even having an ablation date until later in September BUT now, both procedures will be done by the first weekend in September. My only concern, other than all the obvious ones is the major chest surgery following the heart surgery by only one month. I assume all the doctors have spoken and deemed it fine but it just seems to follow pretty close on the heels of the ablation…

Here is the breakdown;

July 13 & 14th – IVIG
July 23rd – Ablation
August 31st & September 1st – PLEX
September 3rd – Thymectomy followed by 2 months of recovery – give or take…

So there it is then, not much ha ha today but I think I made up for it with sheer information… so, for christmas this year I might be getting a big bundle of “better”……