IVIG is like a good, strong cup of filter kaapi that calms the whole system down—it works for all three, especially when things are severe. Plasma exchange is more like carefully picking out the spoiled sombu from the rice, removing the bad antibodies, very good for GBS and myasthenia. But in my small town, IVIG bottles are as scarce as honest politicians. So I often use what we have FOR THE PATIENT IN FRONT OF ME, not by the book. Seeing my son count coins to order stock taught me that the right treatment is the one you can actually get.
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