We were watching all of them like a hawk, because starting at 12:15 p.m. Dominic began receiving the very drug that put him in the ICU five days ago.
When he first got rituximab to treat his PTLD (post-transplant lymphoproliferative disorder), they started it at a rate of 5 ml per hour. Things were going fine so they upped the rate to 10. Five minutes later his temperature spiked, he was shaking and moaning in pain. By the next day he needed a ventilator to breathe for him.
Now, as his body is finally recovering, we are giving him rituximab again. Brilliant.
We feel we have to because of the seven known cases of PTLD in a bone marrow transplant patient this young, the only four who survived got rituximab. Our doctor also mentioned there's less chance of a bad reaction the second time around. Right, because that's going to quell our fears.
What the doctors won't do is give him the medicine at the same rate that caused the reaction. But he needs 180 ml of it. At five per hour, that's 36 hours. He needs it every three weeks until September.
Pack your bags.
The first hour was the most worrisome. Was it the flow rate or the amount in his system that caused the reaction last time?
But the hour came and went. Then another hour. It's been nine hours now and he's just as zonked out from morphine as he was the past five days.
If he keeps this up they plan to turn off the ventilator and remove the tube down his throat tomorrow. Already we're weaning him off the morphine so he can wake up. There's talk of heading back to Unit 1 Wednesday.
Just in time for bingo and pizza again.