Rituxan in my future!

[Sangye]

Dr Seo told me the decision to use 2 or 4 infusions has been based on which center is doing the infusion. It sounds a little crazy, but he said some centers (eg Mayo) have just always done 2 while others (eg JHU) have always done 4. So they each kept doing what they'd always done!

I did 2 rounds of 4 infusions in the past, but this February he decided I would do only 2. He said there is more research now that show that 2 infusions are as effective as 4. Also, since I have terrible side effects from it, he thought I might do better getting half the dose. I did do better (it was still pretty awful) but I have my doubts as to whether it worked as well. I don't think you should extrapolate from my experience, though.

[Kami]

My first infusion will be on May 4th so I have no personal experience with it yet but my doctor told me that I would have the same amount of medication in either 2 infusions 2 wks apart or 4 infusions 1 wk apart and he said that the 4 times is easier on you for side effects, that was his reasoning. I can see where that would make a difference on the center as far as scheduling and availability too.

[Sangye]

It's not correct that the total dose is the same. Each infusion is based on your weight. They can't give you twice as much rtx in one dose. Maybe what he meant was that the effectiveness of the drug is the same.

Most people don't have side effects beyond a little fatigue the day of the infusion. Very few people (I am one) have debilitating weakness that begins with the first infusion and increases with each consecutive infusion. It usually goes away 6 weeks after the first infusion. Four infusions were way more debilitating than 2 for me.

[ScreaminMeanie]

I'm curious about that, also. My rheumy believes in the 4-treatment regimen over the 2. The only downside for me is the two extra days of leave time I'll have to burn, when my leave balance has already dwindled pretty low.

(In case that sounds like a non-issue to some, where I work, running out of leave can be grounds for termination. "Can be." Not "is." But why take chances? )

[drz]

Yes, I do have insurance. I still feel a bit of concern about getting approval. Worse - I have a 20% co-pay which may put us in the poor house. I'm not sure where I stand on the annual out-of-pocket maximum, but I know it hasn't been satisfied yet this year.

With a 20% co-pay and RTX treatment i am betting you will make it pretty soon. Hope it isn't too high.
Happy Easter weekend.

[ScreaminMeanie]

I know what you mean, drz! I'm actually debating whether to do the treatments before July 1 (beginning of new fiscal year) so that I only have to shell out the remaining out of pocket for this year or wait until after July 1 so that I get one huge bill at the beginning of the year, have all year to pay it off, and most everything else is free for the rest of the year. Either way, I'll almost certainly end up meeting my out of pocket expenses for both years, so the money WILL be spent. It's just a matter of WHEN. LOL

[drz]

I'm curious about that, also. My rheumy believes in the 4-treatment regimen over the 2. The only downside for me is the two extra days of leave time I'll have to burn, when my leave balance has already dwindled pretty low.

(In case that sounds like a non-issue to some, where I work, running out of leave can be grounds for termination. "Can be." Not "is." But why take chances? )

I think the preference depends upon where they trained and what protocol happen to evolve at that place. Near as I can tell there is no research evidence to prove or disprove one protocol is more effective than the other, so it is the doctor and patient's call, or unfortunately in some cases a bureaucrat somewhere that doesn't know any thing at all about what you need or want.

[pberggren1]

Man oh Man! 20% is a lot to pat for rtx.

[ScreaminMeanie]

Man oh Man! 20% is a lot to pat for rtx.

No kidding! Chances are pretty good any policy's out of pocket expense is less than the 20%.

[vdub]

I'm retired military (USAF) and most people think we have a free ride on medical. Not so! I pay 20% of all my expenses. So far, it hasn't been too bad because I pay 20% of what the insurance company knocks it down to. Hopefully, that will be the same with you, i.e., the insurance company knocks it down to x dollars that they have agreed upon and then you pay 20% of that. It's a lot more palatable. (BTW, we (retired mil) get zero dental, optical or hearing.)

Best of luck with rtx!