Primary Immune Tribune
August 2014
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IDF Question and Answer

Question:

What suggestions do you have for fatigue associated with CVID?

Answer:

It is always important to figure out why you are fatigued. Obviously, when you don’t feel well or have an active infection, you are tired. It is a normal body response. But if you don’t have an infection and are tired, then other causes of fatigue need to be considered. You may want to check to see if you are anemic. Sometimes anemia can be caused by a deficiency in iron. Your healthcare provider can determine that and suggest that you add an iron supplement to your daily routine. Another source of fatigue can be stress. The importance of a healthy life style which includes a balanced diet, adequate rest and exercise cannot be underestimated as a stress reducer. Depression can also be a source of fatigue. The incidence of depression in people with chronic illness is well documented in the literature. Your healthcare provider can determine if you are depressed and suggest ways of treating it. Another common cause of fatigue in CVID is lymphoid interstitial pneumonia (LIP) which can alter the gas diffusion capacity of the lung and result in fatigue. Lung function testing could be necessary.  

The bottom line is to discuss your fatigue with your health care team and together see if you can determine what is causing it. You should never assume that fatigue “goes with the disease” and that there is nothing that can be done about it.


Question:

I do my Ig therapy subcutaneously and have been really happy with that method, except sometimes I have itching at the site of insertion. What causes this and what can I do to avoid it?

Answer:

There are several reasons why you might be experiencing an itchy feeling. Itching can be caused by the immunoglobulin leaking into the skin, instead of going into the subcutaneous tissue. Make sure that you do not prime your tubing all the way down to the needles. You want to remember to do a dry insertion.  

You also need needles that go all the way through the skin and are completely into the subcutaneous tissue. The shortest needle isn’t always the best. Some patients eliminate itching by extending the length of the needle by a mere 3 millimeters.  

Sometimes, itching is caused by the stretching of the skin as the drug is infused. Some patients prefer to do their infusions in the same general area as opposed to rotating sites so that they go where the skin has already been stretched a bit. You may also prefer to use extra sites to reduce the amount of drug in each site.  

Itching can also be due to local sensitivity to adhesives. If the clear plastic dressing contained in your needle sets is irritating, try using regular adhesive tape. This comes in plastic, paper, silk and other fabrics so you should be able to find one that doesn’t irritate your skin.

As always, be sure to talk with your healthcare provider for more information.

 


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