Praise then darkness, and creation unfinished

My Ocrevus infusion went smoothly. I got to the hospital half an hour early, partly because I woke up a bit earlier than the already early time I had set my alarm. So, I also left the house a little earlier than planned, then made very good transit connections.

This time, I asked the nurse to use my right arm for the IV, but she had trouble finding a good vein, and asked a more experienced person to set up the IV. When my right right forearm didn't work either, I told her to use the left arm, which did. She suggested trying my right hand, but there are just too many nerves there.

Since I've had these infusions several times before without problems, she ran the IV drip faster than usual. I was done with the infusion at about noon, meaning I got to leave at 1:00. I brought lunch, leftover vegetable frittata, which I ate while sitting around for them to low-key monitor me (meaning there was nobody in the room with me, but plenty of staff nearby where they would have head me if I'd called for help.

When I was done at the hospital, I took the bus a few stops, then bought a cup of tea from Flour, and drank it sitting on an Adirondack chair in Harvard Square. The chair has a plaque saying it was paid for jointly by the city of Cambridge and a group of Harvard Square businesses.

Once caffeinated, I took a bus to Penzey's in Arlington and restocked our spices. I'm a little low on whole green cardamom pods, but those are expensive enough that I'm going to wait and see if Bill Penzey decides to offer a discount on those specifically. The cashier doesn't think they've had a sale on cardamon specifically, but they have had sales on things like everything Mexican, because Trump was slandering Mexicans; a Russian seasoning blend to make the point that the problem is the Russian government, not ordinary Russians; and everything starting with F or N (because of right-wing hate speech using specific nasty slurs; so maybe Bill Penzey will decide to discount everything starting with C. More likely, I'll put cardamom on the list when I'm down to a couple of weeks' supply -- I don't use it that fast, but it was worth looking at the current price as long as I was there.

I got an automated message via MyChart yesterday, saying "you have a new test result". I logged on, and it was a "miscellaneous lab test," with lines for "result" and "test name," and columns for "Component, Your Value, Reference Range, Flag" -- all entirely blank.

I looked at the date and followed up with my neurologist, who replied, saying "This is the B-cell measurement and it came back zero which is the goal while you take ocrevus." So, good I guess, but it's hard to be entirely cheerful about the way the medication, doing what we need it to, is squelching my immune system. (And three years ago I would have shrugged at this.)

I had my twice-a-year Ocrevus infusion this morning. They took blood to run some tests my neurologist wanted: the MtAuburn labs and MyChart are efficient. They took the blood around 9:00, and the first results were available at 9:45. My Vitamin D levels are excellent! 71.1 ng/mL, with the "good" range being 30-100. My neurologist was aiming to get it up from about 35 to 50 because they think there's a connection between Vitamin D and MS. Note: a couple of years ago the "reference range" was being given as 20-100; if you were at the low end of normal by that standard, they may now consider you to be deficient in vitamin D even if the actual number hasn't changed.

Also, the Transit app is now asking: do you think the bus stop is accessible? how crowded is your bus? did the bus arrive when you expected, or significantly early or late? and whether the other passengers are masking. For my bus home, the answers were yes, accessible; somewhat crowded; about when I expected (for the revised arrival time, but there's no room to be that specific); almost everyone was masking. (I took a Lyft to the hospital, because an 8:30 appointment would have put me pn a rush hour bus, and with little slack if a bu trips was cancelled.) I wore my boat-style N95 mask for about several hours, removing and restoring it a few times to eat, and twice to take pills. I continue to be pleased with these masks.

Pulling this out of comments: voidampersand found a small study showing good T cell response in patients being treated with Ocrevus, like me:

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab954/6430423

The authors note the small study size, and that they were unable to correlate T cell levels with clinical protection, but this is still good news.