Hi,
I’m just wondering what other people’s experiences are of having had Rituximab infusions and working in a primary school.
I have been signed off by my GP as he feels that the risk of infection is too great for me . I am 58 and I also have Lupus SLE.
I had my first infusion in January and will be on the 2yr protocol for rituximab.
Thanks for any advice shared 🙂
I'm on rituximab and personally still shielding, I also know of other people on rituximab who have had to stop working in schools because they kept getting infections which in turn prompted them to flare. If a primary school you're at particular risk to things like chickenpox, though there tends to be lots of illnesses flying around.
In terms of individual risk assessment, particularly with things like Covid, my understanding is how ill people are is dependent on a lot of factors, not just being on ritux. My reason for still shielding is rituximab + kidney involvement + being on 3 medications to treat my out of control blood pressure due to vasculitis. So I have multiple confounding factors that affect my risk profile to getting particularly sick. Age works in my favour statistically as I'm 33, but the other factors are outweighing my age in my risk assessment. Others might have less confounding factors so might feel safer.
There are others on rituximab who are a bit careful, others still shielding like me, and others who don't take any precautions.
In your position I'd likely accept being signed off, but everyone's circumstances are different, and I'm on the more risk averse side, mainly because how incredibly ill I was at diagnosis is still clear in my mind, and I don't want to repeat that any time soon.
Hi Grizzly- bear
Thanks so much for your reply . I too have kidney but also lung involvement hence my GP’s concern for me to be in school.
Occupational Health have recently been involved and their Dr did say he would support me retiring on ill health grounds if that was considered appropriate.
I suppose for me , I’ve always attempted to power through and tried not to “give in” to my conditions but there comes a point when you have to put your sensible head on.
As you so rightly say for your situation but I can concur with you , I don’t want to be really poorly again so maybe retiring is going to be the way forward.
I just miss the children and my amazing friends at school so much !
Take care,
Seren
Hi Seren65. I don’t know whether there is a financial consideration re sick pay or SSP and that can make a difference to people when calculating the risk. You have to face facts that working in a primary school you are more likely to get Covid than not and as Grizley says it all about how ill you’re going to be regarding any contributing factors. A recent Lancet article dated March 2023 published the results of a trial involving over 400 people who caught Covid who had been on more than one dose of Rituximab and it concluded that only 5% had moderate the severe symptoms, 1 died. And that’s a great improvement on the limited date we had at the height of the pandemic but beware that 5% most likely had other underlying conditions. Nick.
Sorry forgot to say, all were fully vaccinated.
Hi Nick
Thanks so much for the interesting data you’ve shown. I do admit that financial considerations do come into play but health has to be the top priority, doesn’t it. Due to the fact that I have other underlying health conditions, I think I need to be sensible. As I said to Grizzly- Bear, Retirement on ill health grounds has been suggested so I think that realistically, that may have to be my next move .
I had just wondered if other people had continued to work in schools whilst immuno- suppressed.
Seren
Hi Seren, I had a similar situation, I started my treatment just before Covid came upon us. I was a Self Employed Accident Investigation Trainer for the Rail Industry. I continued while on the treatment which was Cyclophosphamide and high dose steroids until lockdown and in the August of 2020 was fortunate enough to be able to train people from home via Teams and Zoom etc and it was going really well. Last year when the country opened up completely companies understandably wanted to go back to class based training and that’s when I looked at the risk and thought I am 60, I don’t want to take the risk and I want to finish at the top of my game so in July last year ran my last course from home and called it a day.
It’s been hard at times adjusting after nearly 40 years on the Railway, going from working in a job I loved to getting up in a morning and thinking what shall I do today? Winter came and it all hit home “you’re retired”! But I realised that doing nothing wasn’t an option so started to do things I had been putting off for ages. My latest venture is a fitness drive and I am very strict about it but I seem to have more go in me. I do my jobs, train for an hour and make sure I have 2 hours on the sofa. It sounds simplistic but I am used to it now and know the risk of me not being poorly is a good trade off. Take care. Nick.
Hi Nick
I think that’s what’s hard for me to get my head around. My heart is saying I want to be in school with the children - working with children with addition needs and/ or emotional difficulties but my head is saying that the sensible thing to do is retire!
I think ultimately I have no choice and most people seem to be of the opinion that working in school is a risk too far . My GP likened it to dealing with germ warfare .
Glad you’re finding your way through retirement and setting yourself goals .
Take care
Seren
Hi Seren. I think the other consideration is not just Covid but other infections too that could be quite damaging. I have never been a quitter but sometimes you just have to stop and think. Nick.
That’s a difficult decision for you. I have had rituximab infusions and have ended with Bronchiectasis as a result of so many chest infections and a little help from vasculitis. Unfortunately I can blame my young grandchildren for sharing their germs for some of my chest infections. Some have been serious enough to put me in hospital. Personally I wouldn’t want to risk being around so many young children. Good luck in whatever you decide.
Hi Mooka
Thanks for your reply. I too have Bronchiectasis so that does have a big impact on my lung function some days. As you say with your grandchildren sharing their germs, a lot of our children in school, are very generous with how they share their germs, also!
I think realistically, I will have to take ill health retirement if I want to protect myself as best I can. I had just wondered whether people had found a way to motor through without succumbing to infection. You are proof that it is challenging to do so .
Take care,
Seren
I do have very low immunoglobulin levels which doesn’t help. Some people with Bronchiectasis use a nasal guard spray and I heard on tv someone suggest using Vaseline as a barrier. I have no idea if they work or not. However I think children also like to leave their germs on surfaces so you would be up against it.
Sorry to hear you have low immunoglobulin levels. My bloods are starting to stabilise but they’re taking their time!
I agree with what you’re saying about germs left on surfaces - so many opportunities to pick up these germs.
I just need to start thinking of this as a new chapter in my life!
Seren
I'm right there with most everyone else.
56 yo Physical Therapist , i'm a geriatric specialist and treat seniors at home. At least they are mostly at home but they can have transmittable conditions. I've been pretty lucky and have avoided any bad illness over a year and I wear a KN95 mask all the time. It's pretty comfortable and I've become used to it. I still avoid indoor busy places but I am living and wear mask unless outdoors. I too need to keep working at least until 60 and I weigh the odds on a regular basis. In the US I don't have a good option to retire now and being very vigilant with masking and had washing is working so far. But, you always wonder what you are exposed to every day. I've had my first real flare and it did worry me a bit, even though I was able to get it under control. But, I've had pretty severe episodes in the past with pneumonia and that is not fun.
Being around children in enclosed spaces in tough. They are carriers for so many germs. But, I like you love what I do and weigh the odds regularly. I think if I ever have a significant episode from catching something, I'd rethink my options.
Hang tough.
I do not have vasculitis but I’ve had several rituximab infusions for an autoimmune kidney disease, and I’m immunocompromised. My employer recently forced me back to working in person. My work is easily accomplished remotely but they say everyone has to come back regardless of their situation for “collaboration”. All our meetings are still remote. They also say since I have a door I can stay in my office with the door closed all day to avoid Covid. Pretty ignorant and indifferent of them, huh? I was a preschool teacher for 20 years, I can’t imagine being immunocompromised and working in a school now. Covid changed everything for some of us
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