My first Remicade® in France

I’ve just got back from my first infliximab infusion in France. Infliximab (or Remicade®) is the regular treatment for my Crohn’s disease. I’ve been taking it for just over two years in an attempt to avoid further surgery. It has worked quite well and I have an intravenous infusion every 8 weeks in hospital.

The high cost of the Remicade® and the trip to hospital every 8 weeks was the reason I needed to get my health care well and truly sorted out as soon as possible after arriving in France.

My appointment was for 8.30am and I got there on the tram in plenty of time, in case I got lost (which I did) or I failed to explain who I was and why I was there (which was no problem).

I was shown to my room, which had amazing views over Caen from the seventeenth floor of the hospital block (not good for my vertigo though). I was offered breakfast and tucked into French bread and a bowl of black coffee.

The nurse looking after me weighed me, looked at my blood results (which I remembered to bring) and explained clearly in French what was going to happen and that I would be there until about 3.30 or 4 o’clock.

The consultant in charge of the unit came and introduced herself to me and asked – in English – a few questions she had for me after reading the letter from my gastroenterologist in Caen and my consultant in the UK.

A junior doctor then came to see me, looked at my blood results, my weight, asked me, in French, if I was allergic to anything and if my general health was okay and then wrote up my Remicade® prescription.

The nurse put a cannula in my arm just before 10am. She was a bit worried that my veins were small and then, when needle was in, she was amazed how the vein she picked suddenly changed direction. I reassured her that they were always like this and it seemed to help her calm down a bit.

The cannula looked very sturdy and 21^st century – I don’t think the first priority here is finding the cheapest cannula available on the world market. Immediately after the cannula was in I was hooked up to a litre bag of saline which was run in slowly at 125ml per hour.

I was then given a small dose of steroid and of anti-histamine. This is a precaution against allergic reactions to the Remicade® and is not uncommon, but I hadn’t had this before in the UK. This was run in intravenously over 10 minutes and then I was left on the normal saline until 11.30am.

At 11.30am the Remicade® was set up and run over two hours. I had a hot lunch – egg salad, beef stew and potatoes and bread and cheese (no wine though) – and settled down to finish the book that I’d started earlier.

I was told that I needed to remain in bed, lying down, while I had the infusion and to rest for two hours afterwards. Throughout the infusion and for the rest period an automatic blood-pressure machine took my blood pressure and pulse every 15 minutes and a nurse popped in 3 or 4 times an hour.

The IV wasn’t hooked up to a pump, it just ran into my vein, in the old-fashioned way. So the infusion ran a little longer than the two hours. But that was fine and I finished my book – ‘J-Pod’ by Douglas Coupland, which was a good read.

Everything was finished just before 4pm. I was given a wallet full of documents to take to the ground floor, got my next appointment time for 8 weeks, said my goodbyes and I was off.

I wasn’t entirely sure what I had to do will my wallet of stuff or where on the ground floor I had to go – it’s one of those things that people just expect you to know and then are utterly bemused when you try to explain there is no such paperwork in the NHS.

Anyway, the woman on reception directed my to where I needed to go and the clerk in the discharge office spoke a little English and took the wallet from me and copied my social security certificate and the letter for my next appointment. I checked that I didn’t have to do anything else or send any forms anywhere (I didn’t) and I was finally off home on the tram.