Using a Nurse to Administer a Home Infusion of Solu-Medrol for a MS Exacerbation
Recap of my First Infusion
This is the second part of a series about my latest 3 day Solu-Medrol infusion. If you missed Part 1 you can read it now. It is my deepest desire that a blow-by-blow account of the therapy, will demystify it for anyone new to the infusion process. While every one's infusion might not be the same, the basic guidelines are followed for all home infusions. Of course, as stated previously, your very first infusion will have to take place in a out-patient or hospital setting, to determine your tolerance of the steroids and to monitor your sugar levels.
Today, I will review the procedure my nurse followed and discuss the actual set-up of the infusion. I will conclude with side effects felt and how long it took me to get to sleep.
Reuniting With My Nurse
Yesterday's infusion started off very well. Seeing my old nurse and friend was very enjoyable. We hugged and laughed and caught up briefly on our lives since we last saw one another 4 or 5 years ago. I was so glad she was still available to help me. She was surprised I requested her by name, wondering which of her patients wanted her back. She said when she found out it was me, she was happy about it.
She arrived at my home about 1:30 pm, within the time frame she gave me. I love her punctuality, the sign of a true professional. After the small talk was concluded, she asked for details about this current relapse. She then asked why I waited so long to get help. I told her I was hoping I just needed to give me body more time, and she said she understood.
She mentioned she understood why I didn't want to start back on Copaxone as she wouldn't want to have to inject herself everyday either. See why I love this woman? She knows how to empathize without being condescending. She agreed that I lasted a long time without taking any of the injectables and hoped that going back on Copaxone would get me back to where I want to be, especially after the steroids have a chance to kick in.
From that conversation we went to the dreaded needle insertion.
Setting-Up the IV
Even though it has been quite some time, she remembered not only my strange acting vein, it has wiggled unexpected, just as the needle is being inserted. Making it harder for her to thread in the IV line. She also remembered my relaxation readiness drill. Once she does the alcohol swipe, I nervously state, "OK, wait a minute, wait a minute, let me look away and get myself relaxed!" She smirks, "Alright, look away and relax . . . are you ready?" "Yeah, I'm ready now." "A little pinch" she says. And amazingly, the needle was in. I shockingly proclaimed, "we're done?" "Yep" she says, "that's it" It was one of the smoothest insertions I've had in quite some time. I guess there's some good that comes out of not needing an IV on a more regular basis - your veins have time to heal. Of course, although relatively painless, my vein had to show off just a little bit and decided not to stop bleeding. It wasn't a gusher, just enough blood to irritate my nurse. She got it under control though, no vein was going to make her have to reinsert another needle. With the bleeding stopped, she taped the line down, fit the sleeve over it and we proceeded to the next step. What's called using the SASH Method of training.
SASH stands for the order I follow in administering the IV.
- Inject the saline solution into my line to cleanse the tubing.
- Hook-up the medication or antibiotic to the tubing.
- After the Solu-Medrol is finished, unhook the ball device
- Flush the line with Hebron so that the blood doesn't clot
It only takes 90 minutes for the IV to run, it takes a couple of minutes to unhook everything and apply the Hebron and then you are all done until the next infusion. You just have to make sure to keep the line safe and secure by tucking it into the sleeve you are given.
I have the line put in my left hand since I am right-handed. My healthiest vein is located right below my wrist, so it is not in the way. The sleeve gets a little itchy especially when the weather is hot, but nothing that is so annoying it can't be tolerated.
I show special concern when sleeping, as I don't want to dislodge the IV line, but since I'm sleeping that long a period of time, it is an easy precaution to follow. I don't sleep on my left side until the treatment is over.
The Solu-Medrol Ball
This method of the delivery is the greatest thing since sliced bread, wheat not white bread. I was happy there was someone who put a picture of it on google so that I could show it to you. As you can see, no poles or necessary, you just hook it to the line in your arm and you are good to go. Want to do some chores, or run to the store? No problem, it is small enough to slip in your pocket or your purse and take it with you.
It works on pressurized power and has a unique look to it. As you can see it is clear, but upon closer examination it actually has two bladder type containers. The outer container is made of durable plastic that cannot be punctured. Then there is an inner bladder which actually carries the Solu into your line. As the Solu is delivered that inner bladder collapses on itself. By the time the IV is finished you can see it has all been discharged and the inner bladder is empty.
I don't know if you use the home transfusion method or not, but if you do, I highly recommend asking for the solu ball instead of the infusion bag. It makes life much easier.
First Day Side Effects
As first days go, the side effects weren't bad at all. That annoying metallic taste kicks in about 20 minutes into the infusion. Always a pleasure. For me it slowly decreases in about 6-8 hours.
The IV didn't begin until a little after 1:30, so the taste lasted into the evening hours. However with an earlier start, comes an earlier disappearance of the taste.
Almost immediately, even with the nasty taste in my mouth, I found my self starving. So the overwhelming desire to eat everything in sight, was my constant companion for the rest of the day.
I noticed a few heart palpitations, nothing really scary, just enough to get my attention. I commented on it to my husband, and he told me it wasn't any wonder considering all the steroids hitting my system. One thousand milligrams is a lot, even when it is condensed into a small circular object. Oh and a very slight headache at times as well.
Bladder Voiding seemed to occur rather quickly as well. I guess your body just wants to empty out all the toxins as soon as possible. Or maybe it is just that 1,000 milligrams of any thing will make your bladder just a tad full.
Insomnia of course becomes evident when it is your normal bedtime. I was up for 20 straight hours. Finally around 1:00 am this morning, I thought I just might be tired enough to begin my wind down procedure. I took 1-1/2 of my normal sleeping pill dosage, turned on my MP3 player and around 2:00 am I finally fell asleep. I was awake by 6:00 am, only 4 hours of sleep, but it was four quality hours, so didn't feel unusually tired.
Another Experience of Solu-Medrol Use
Day 1 Concluded
This concludes day one and Part 2 of my 3 day steroid odyssey. Tomorrow, I will report on how my steroid infusion beginning this morning and ending with my ability to sleep tonight, ended. I'll take note of any thing strange and any side effects.
So far so good though. I hope it continues!