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Subcutaneous Ig Infusions Part 1: Supplies

This past week I did my monthly order of my Ig meds (Gamunex-c right now) and supplies. Since I’ve been doing this once a month for nearly five years now, it is totally automatic. I know all the names of the supplies, the amounts I need, the sizes I need, etc. But as I was ordering this week I had a flashback moment as I was mechanically naming off the supplies I need in this month’s shipment to when I first started out–it was the weirdest thing learning all the special names for squares of plastic tape and the numbering of tube sizes and needle sizes. And I also remember it was a little overwhelming at first. So for today’s post I’m going to go over the basic supplies for a Subq Ig infusion.

Typical Subq Supplies List:

  • Premeds – Most people take premeds to help limit side effects from the infusion. The most common premeds are Benadryl and Tylenol. I use 25mg of Benadryl and 650mg of Tylenol.
    • Tylenol
    • Benadryl
  • Epipen – If you’re doing an infusion at home, whether it is IV or Subq, you have to have an epipen on hand in case of a severe reaction. When you’re being taught to do your home infusions, you will also be taught how to use the epipen.

  • Tegaderm – These clear, stretchy tape-like things are used to keep needles in place during the infusion.

  • Medical tape – You may have a variety of uses for the tape. I use some at the bottom of the tegaderm as extra help to keep the needle in place, even if the tubing gets caught on something.

  • Numbing cream – You put numbing cream on 20-60 minutes before your infusion in the places you are going to stick the needles. It helps it not to sting so much when the needle goes in.

  • Bandaids – I figured you wouldn’t need a picture. Often you’ll need to put a bandaid on each of your sites for a while after you’ve pulled the needles out at the end of the infusion.
  • Tubing – tubing, or rate tubing, controls the speed at which the medicine is pushed into your sites. Different numbers on the tubing correspond to either faster or slower rates. Right now I use F120 tubing, which is a pretty slow rate. When I was on Gammagard I used F900 tubing, which is much faster. It’s all a bit confusing at first but your nurse and specialty pharmacy will help you figure out which rate tubing is best for you.

  • Subcutaneous needle set – For a Subq infusion you can have anywhere from 1-6 or more needles. How many needles you need will depend on the medicine you’re on, the dosage, etc. I think it is pretty typical to start with a 4 needle set and increase or decrease depending on how your body handles it. In addition to the number of needles, there are also different size needles in length and gage (width). The typical length is 9mm. 6mm is for kids or people with very little body fat. 12mm can be used if you are having troubles with leaking. The typical gage of a Subq needle for Ig infusions is 27. Your doctor will typically order the size and gage they think best originally and then you can work with your specialty pharmacy to adjust as needed.

  • Syringes – These are what hold your medicine during the infusion. In setting up the infusion you draw your med from the bottle into one or more syringes, then you hook up the tubing to the syringe and put the syringe in the pump!
  • Mini spikes – These are what you use to draw your med from the bottle to the syringe(s).

  • Gauze pads – These have many uses, but they’re kinda like the tape or bandaids–pretty self explanatory.

  • Alcohol wipes – Also called alcohol prep pads, you use these to sanitize your skin before you stick the needle. You can also use them on surfaces to sanitize– like if you have a plastic mat instead of a sterile drape to set your stuff up on, you’d need to sanitize it with the alcohol wipes before each infusion.

  • Sterile drapes – These provide a sanitary surface for you to set up all your infusion stuff on.

  • Infusion pump – Your pump pushes the medicine into your tubing and through your needles into you! Seriously be grateful for your pump because pushing the syringe yourself for hours at a time would be super tiring.

  • Sharps container — At the end of your infusion you put your used needles in the sharps container. When your sharps container is full your specialty pharmacy usually has a prepaid box you ship it to their disposal facilities in.

Ok so I think I covered all the basic supplies you’ll be handling with your Subq infusions, but if you’re still confused no worries! This is just part 1 remember? I’ll have further posts about Subq infusions in the future as well as a video showing you how I do my infusion 😉 In the meantime, if you have ANY questions about Ig infusions please feel free to ask me! Comment, shoot me an email- whatever. I’d love to help you out if I can. You’re not alone!

100 Little Things That Make Me Happy

This month has been rough, no doubt about it. It seems to be the winter from hell, as far as germs are concerned. Since the semester started a month ago, I’ve had two separate stomach bugs, a strep and sinus infection combo, and now a cold. And it’s not just me–my family members and schoolmates with normal immune systems have been sick almost as much! So what are we to do? Well we could dwell on our misfortune. We could freak out about the Petri dish in which we must live our daily lives (and trust me I have). But a monk from Vietnam I’ve been reading recently might have a better idea; in Peace is Every Step Thich Nhat Hanh talks a lot about mindfulness. At a really basic level, I think of mindfulness as noticing the beauty and little blessings all around us every day. So this week I made a list of 100 of those little things that make me happy.

  1. Random 60 degree days in the middle of winter #Virginia
  2. Opening a new tube of toothpaste
  3. Waking up without a headache
  4. Being called “aunty randa” (by my niece- from anyone else that would be weird)
  5. The space heater in my room
  6. Chocolate
  7. Purring cuddles from my kitty
  8. Purple and orange sunsets
  9. Not having to be on antibiotics
  10. My flannel sheets- so cozy
  11. My flying pig pj pants
  12. Having time to read for fun
  13. Finishing a long reading for class that seemed like it would never end
  14. Class being cancelled
  15. Goodbye/Goodnight kisses from nieces
  16. Family movie nights/ infusion nights
  17. Acing an assignment
  18. Texts from my parents, always politely signed Love Dad/Mom at the bottom so I know who they’re from
  19. Family dinners
  20. Getting a chance to play the piano
  21. Being treated by a doctor as an equal partner in my care
  22. Walks
  23. Feeling my room get lighter in the early morning when I can’t sleep
  24. Corny jokes- especially my dad’s
  25. Pictures of lighthouses
  26. The sound of rain at night
  27. A cup of hot cocoa
  28. Coloring
  29. Birds singing/ chirping
  30. Baby/ toddler giggles
  31. Finding a great parking spot
  32. Autumn leaves
  33. The smell after a spring rain storm
  34. Getting a great night’s sleep
  35. Listening to scores from my favorite movies (HP, LOTR, Hunger Games, etc)
  36. Parks and Rec
  37. Making others laugh
  38. Deep conversations with people I care about
  39. Hot showers
  40. Getting my back to pop
  41. Finding a favorite pen and then writing with it
  42. Learning something new
  43. Writing on the thick, smooth side of the notebook
  44. An empty laundry basket
  45. An empty sink
  46. Having special chocolate in a secret chocolate stash
  47. Stealing chocolate from my dad’s “secret” chocolate stash
  48. Fresh mangoes and pineapples
  49. Getting through my entire To Do list
  50. Sweatpants and hoodies
  51. Finishing a bottle of antibiotics/ steroids/ other loathed medicine
  52. When anyone, especially a professor says “as it were”
  53. Quoting favorite tv shows/ movies/ books whether or not they are actually applicable to the situation
  54. Being greeted by one or more wagging tails at the door
  55. Cold nose kisses from my cat that often jerk me awake at night (I think she thinks it’s funny)
  56. Having a fire in the fireplace (and therefore having an actual fire place)
  57. Remembering what I’ve been trying to remember that’s been driving me crazy
  58. Putting on a clean pair of socks
  59. Remembering everything I needed at the grocery store
  60. Freshly changed sheets
  61. Having no copay
  62. My cat socks
  63. Spontaneous study breaks when a niece or two or three escapes their parents and wanders into my room
  64. Every day, hour, minute I’m not sick or in a lot of pain
  65. A clean and organized work space
  66. When I know just what to write
  67. Finishing an essay
  68. Eating solid food without pain/nausea
  69. Pulling out the needles at the end of an infusion
  70. Waking up and knowing I don’t have to go anywhere that day
  71. Getting to go to church on Sunday
  72. Not having to rush in the morning
  73. Doing something outside my comfort zone (it’s a very small zone)
  74. Alone time
  75. Feeling good enough to work out
  76. Waking up without an alarm clock
  77. When a medicine has no bad side effects– oh wait that doesn’t happen… When a medicine has relatively few bad side effects…
  78. Cozy sweaters
  79. Reading a good poem
  80. Stepping on crunchy leaves
  81. Feeling my kitty at the foot of my bed when I turn over in the night
  82. Pictures of Christ
  83. Skyping/Face Timing the parentals on Sunday
  84. The smell of brownies baking (or any goody really)
  85. Getting a big glob of mucus out of my chest or sinuses
  86. Not coughing (remember I had whooping cough earlier this year so the last few months not coughing has been the cherished exception)
  87. When I catch someone doing something silly because they think they’re alone
  88. Anything Harry Potter
  89. The abridged version of Les Mis (so much easier to readdddd)
  90. Old fashion soda bottles
  91. Miniature pigs (I will have one someday!)
  92. Documentaries/ books about inspiring people
  93. Psych and Monk being on Amazon Video now
  94. Warm clothes fresh from the dryer
  95. Sunshiny days
  96. Watching lightning during a thunder storm (if it hasn’t already given me a migraine that is)
  97. Naps
  98. Christmas lights
  99. Finding a good song on the radio
  100. Jar tops that go clicky-clack

 

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Dad’s “secret stash”

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Bestower of nose kisses

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Flying pig pjs and kitty socks #thuglife