Immunology Update

From my post Consult in Boston, you know that when I saw Dr. Bonilla on September 23rd, he suggested that my IVIG dosage be increased. Although he sent his recommendation to Dr. Steingart, my dosage was not increased. At first the problem was that Dr. Bonilla suggested a dosage increase to 12.5G IVIG weekly. Baystate was not able to get this allotment. To give me 12.5 G, half a bottle of IgG would have to be wasted and it is way too expensive for that. Since it wasn't possible to get the 12.5 G, Dr. Bonilla then suggested an increase of 15 G every 10 days. The problem with this is that it would mess up the infusion cycle. Sometimes my infusion would fall on a weekend in which case it would either be pushed forward or backward. So week after week, I remained at the same dosage. I continued to get sick and fight continous infections. Since the dosage hadn't been increased, no improvement was experienced. This became very frustrating. Finally, after seeing Dr. Steingart on December 3rd, he increased my dosage. I suggested that if we could not get the 12.5 G, why didn't we just increase to 15 G every week instead. It turns out that the pharmacy only gets 5 G bottles in a different brand of IgG. I get Gammaguard. This is the most pure form of IVIg and has the least amount of IgA in it. The other brands cause me to have reactions. So switching brands was not a good idea. Instead, he decided to just increase the dosage to 20 G every week. It is more than I need, but hopefully I will see some improvement. Of course, I expected an immediate improvement and that did not happen. It's hard to remember that IVIg is not a cure and that it will take awhile for my body to experience any improvement. In addition to the dosage increase, Dr. Bonilla put me on prophylactic antibiotics.