Monoclonal antibody treatment in Boerne area for mom going through chemo

2,742 Views | 18 Replies | Last: 2 yr ago by Bayouhobo
jamotoe1
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3:56p, 1/11/22
My mom is in the middle of chemo after a pretty big surgery in early October and both of my parents now have covid. Mom started having symptoms on Saturday and first tested positive on Sunday. Her oncologist can't find somewhere to schedule her for a monoclonal antibody treatment until this coming Sunday.

Any suggestions on other places to look?

I've tried this place https://strac.org/ric and her oncologist is sending a referral to see if we can get a home infusion scheduled, but not sure if it will work out.

She has a worsening cough, sore throat, and lots of mucus. So far her pulse oxygen is doing ok. I'm pretty worried about but, and unfortunately I don't live there.

Any guidance or suggestions for what I should be seeking out for her and when it's better to stay home or go to a hospital.

Thanks!
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88planoAg
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4:10p, 1/11/22
AG
Sorry I don't have an answer for you. I've seen talk on Nextdoor that it is hard to find. Also that a specific type is needed for the new variant as the old stuff isn't very effective. Try cross posting on the San Antonio board, maybe someone in the larger area will know.
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jamotoe1
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4:16p, 1/11/22
Thanks. I just cross posted it.
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BlackLab
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4:25p, 1/11/22
AG
the San Antonio infusion center had plenty of sotro (drug best for omicron) last week. The referral must be submitted online. That's probably the easiest route. Don't let the doc send the referral any other way other than through the online portal on the website or it won't work. Once the referral is submitted an appointment time will be sent immediately via text and email.
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BlackLab
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4:29p, 1/11/22
AG
Availability map here:

https://tdem.maps.arcgis.com/apps/webappviewer/index.html?id=993e2c2079f8487cafcec74e00e84991


Orders must be sent here:

https://www.stateoftexasinfusionhotline.com/s/new-order


Another option my doctor mentioned:

https://www.huddlenurse.com/
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jamotoe1
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4:33p, 1/11/22
Thanks. When I spoke to them they said they can do the referral online or call. My mom said they were calling in the referral earlier and she hasn't responded any further yet. Hopefully I can confirm it got done before they close.
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BlackLab
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In reply to jamotoe1 • 4:35p, 1/11/22
AG
You can call the infusion center to see if your mom's information is in their system. Last week - they told me they would only take referrals via the portal and no other way. If they dont have her info, I would insist that the doctor send the referral through the portal.
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jamotoe1
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4:38p, 1/11/22
Thanks. That is helpful information. It's such a game of telephone (literally) with my parents. I really to get mom to authorize me at all of her docs so I can just deal with it directly, but one thing at a time….
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jamotoe1
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4:41p, 1/11/22
Maybe I can get her doc to send in a rX for Xanax for me at the same time. Kidding….kinda….not really.
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BlackLab
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4:57p, 1/11/22
AG
I would say also make sure she is monitoring her O2. The medical folks on here may correct me but I was told that O2 below 90 was the line of when to seek treatment at a hospital.
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88planoAg
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In reply to jamotoe1 • 5:31p, 1/11/22
AG
jamotoe1 said:
Maybe I can get her doc to send in a rX for Xanax for me at the same time. Kidding….kinda….not really.


I've had people tell me that when their family member was going through chemo the doc did exactly that for the primary caregiver.
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beachfront71
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8:41p, 1/11/22
AG

Last time parents thought they had it I spoke with the urgent care on river road by dodging duck

They required an in person or zoom meeting but had an antibody service that would come to your house to do it

the problem is it sounds like supplies in Texas are low right now .
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Amazing Moves
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3:34a, 1/12/22
Why is there a shortage? Really.. Why?
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Zobel
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In reply to Amazing Moves • 8:11a, 1/12/22
AG
I am not an expert, but the answer I've been able to find is that monoclonal antibody manufacturing is a biologically limited process that is very difficult and expensive.

This article talks about at least one kind of monoclonal antibody production. Not sure if this is how they are being made for COVID, but its a reference point.
Quote:
Unlike polyclonal antibodies, which are produced in live animals, monoclonal antibodies are produced in vitro using tissue-culture techniques. mAbs are produced by immunizing an animal, often a mouse, multiple times with a specific antigen. B cells from the spleen of the immunized animal are then removed. Since normal B cells are unable to proliferate forever, they are fused with immortal, cancerous B cells called myeloma cells, to yield hybridoma cells. All of the cells are then placed in a selective medium that allows only the hybridomas to grow; unfused myeloma cells cannot grow, and any unfused B cells die off. The hybridomas, which are capable of growing continuously in culture while producing antibodies, are then screened for the desired mAb. Those producing the desired mAb are grown in tissue culture; the culture medium is harvested periodically and mAbs are purified from the medium. This is a very expensive and time-consuming process. It may take weeks of culturing and many liters of media to provide enough mAbs for an experiment or to treat a single patient. mAbs are expensive.



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czechy91
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In reply to Amazing Moves • 10:39a, 1/12/22
AG
Amazing Moves said:
Why is there a shortage? Really.. Why?
There were 5 effective monoclonal antibodies that seemed to work well against the pre-Omicron variants which included Bamlanivimab, Etesevimab, Casirivimab, Imdevimab and Sotrovimab. Now with Omicron, it turns out that the first 4 listed above don't seem to really help and only Sotrovimab has success. So given the skyrocketing cases of Omicron coupled with the fact that only Sotrovimab works, it should be expected that there is a significant shortage in monoclonal antibodies.
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jamotoe1
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3:25p, 1/16/22
Well, they cancelled her appointment last night due to lack of supply.
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88planoAg
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In reply to jamotoe1 • 4:00p, 1/16/22
AG
Sorry to hear that. How are your parents' covid symptoms?
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2wealfth Man
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In reply to czechy91 • 6:14p, 1/16/22
AG
czechy91 said:
Amazing Moves said:
Why is there a shortage? Really.. Why?
There were 5 effective monoclonal antibodies that seemed to work well against the pre-Omicron variants which included Bamlanivimab, Etesevimab, Casirivimab, Imdevimab and Sotrovimab. Now with Omicron, it turns out that the first 4 listed above don't seem to really help and only Sotrovimab has success. So given the skyrocketing cases of Omicron coupled with the fact that only Sotrovimab works, it should be expected that there is a significant shortage in monoclonal antibodies.
This absolutely correct; you need to do the genetic sequencing to know which variant you have.
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Bayouhobo
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In reply to czechy91 • 6:23p, 1/16/22
It should absolutely NOT be expected.
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