Frequently Asked Questions About Photopheresis

• Your insurance card (s)
• A photo ID
  
• A snack or lunch if you'd like
• A favorite electronic device or book - each treatment chair/area also has its own TV

You should contact your insurance to verify your coverage and benefits for photopheresis. Our office can contact your insurance if authorization is required.

• Unless otherwise advised by our team, drink plenty of fluid for two days before treatment, especially high-calcium drinks like low-fat or skim milk. Avoid caffeine and alcohol, since they may dehydrate you.
• On the evening before treatment and on treatment morning eat a low-fat meal, since fatty foods can interfere with ideal cell collection.
• You may bring food with you to snack on during treatment.
  
• Do not eat a meal before your treatment if you are having fasting blood work, but bring something with you to eat afterward.

Speak with your photopheresis nurse or physician before taking any medications. They will review your medicines and decide which ones you can or cannot take.

• Use the restroom immediately before you get settled for treatment.
• Because an anticoagulant is used in the IV line to prevent clotting of blood cells during the treatment, you have a slightly increased chance of bleeding from the IV site or from any trauma in the 24 hours after treatment . Use caution in performing any risky behaviors.
• Since UVADEX, a light-sensitizing medication, may increase your sun sensitivity in the 24 hours after treatment, wear UV protective sunglasses and use sunscreen if you must be exposed to direct or indirect sunlight.

Navigate to Morristown Medical Center's main entrance and look for an outpatient parking garage, which is to your right as you drive in. When you exit the parking garage, you'll see a two-story brick building called the Anderson Building. You'll see our center's name, the Emil P. Bisaccia, MD Center for Photopheresis, on the outside. Enter through the Anderson "B" first-floor entrance.

Most importantly, communication between you and your photopheresis team is vital. Other than the initial slight discomfort of the IV placement (which can be reduced with skin-applied medication), you should not feel anything out of the ordinary.

If you experience any other pain, lightheadedness, palpitations or other unusual symptoms, tell us right away.

We will also ask you about any medication changes, significant physical and/or emotional stressors or other issues. Your illness is a chronic situation and your treatment will be ongoing for some time. We want to make your visits as stress-free as possible. Our goal is to focus on your well- being, not just your disease.

When you arrive, you will be registered and undergo an evaluation by our medical director.

After consent forms are discussed and signed, one of our treating RNs will give you a full orientation to the unit and explain the photopheresis process.

During treatment, you will be able to read, watch tv, eat, listen to music or just rest quietly. Treatments normally take two to three hours.

• Your nurse, who will remain with you for the entire treatment, starts by placing an intravenous (IV) line(s) into an arm or hand vein. This will be in place for the whole treatment and, since it is a metal needle, care must be taken not to dislodge it or move the limb around very much. You will also receive a small amount of blood thinning medication called Heparin (an anticoagulant) to prevent your blood from clotting when it enters the cell separation chamber. 
  
• A portion of your blood will be collected via the IV line into a sterile disposable kit within the photopheresis instrument. The machine will then separate and collect the necessary white cells and return the other components to you so that only a safe amount of blood is out of your body at any time. 
• A light-sensitizing medication (UVADEX) will be added to the collection of white blood cells and the machine’s ultraviolet lights will bathe the cells in a specific amount of ultraviolet radiation to activate their immune system function.
• After the measured amount of “light time” the collection will be returned through the same line(s) back to you. The needle will be removed and a dressing will be applied.

You should not feel pain during the treatment. The photopheresis needle is
the same one that is used for blood donation.

To reduce any discomfort, you will be prescribed a cream to numb your skin (lidocaine and prilocaine). We encourage you to apply the cream to your skin 45 minutes prior to the treatments.

Once the treatment has started, you are free to relax.  Most of our patients enjoy watching TV, reading or even taking naps during their treatments.

You may feel tired after completing photopheresis treatment. If you have a question or problem, our physician is on call 24 hours a day, 7 days a week. We will explain how to contact her prior to your discharge.

Your treatment schedule will be determined by the level of your disease and your individual response to treatment. It generally takes a number of weeks to see measurable improvement, although many patients start to feel better even in the early treatment cycles. Response is a very individual and variable process and your treatments will be scheduled according to your personal progress.