Everyday at 9 AM, I go into Sequoia Hospital for an intravenous shot of an high-octane antibiotic – daptomycin, Daptomycin with a capital “D”? – to protect my cow aorta valve. Every day for six weeks; Saturdays, Sundays, New Years Day, at 9 AM. I do not think that I have done the same thing at the same time for six weeks in my entire life, it is very strange – not bad necessarily, but strange – and I am having a hard time getting used to it.
What is also strange is the PICC line in my arm, just below the armpit, that runs through a vain – or artery, I am not sure which – up, through my shoulder, and down to a large gaggle of pipes near my heart. According to Wikipedia, the PICC lines are used when intravenous access is required over a prolonged period of time or when the material to be infused would cause quick damage and early failure of a peripheral IV, and I think that is the case with me. I had a peripheral IV port in my hand that they used for a couple of days and my hand is still sore.
I think of the PICC as a very small, very long, hole that runs from outside my body to, almost, my heart. It is very handy: anything anybody wants in me can just be shoved in through the hole; the Flue Vaccine I forgot to get earlier in the year, a Pneumonia Vaccine I didn’t even know I should have, lunch – I guess. But, and it is a big BUT, protecting that hole from bad stuff getting in is a big deal. A much bigger deal than protecting a IV because any bacteria traveling up the PICC would end up right next to my heart which is what they are trying to protect, in the first place, by pouring in the dosages of antibiotic.
Tuesday is the changing of the covering-dressing day and it is sort of emblematic of my whole Sequoia experience and – by only slightly fantastical extension – our health care system.
The changing of the covering-dressing is almost ritualistic in its detailed, loving, complexity; it is driven, in large part, by outside vendors coming up with new, improved, and increasingly expensive ways to do it; it is staggeringly wasteful; and once you see it, it is hard to think of a cheaper, simpler, way to do as good a job. First the nurse takes a sterile envelope containing sterile gloves and opens it to to form a sterile area, then she empties all the cleaning supplies and sterile dressings on to the sterile area. After she puts on the gloves and facemask, my existing dressing is removed and the area cleaned.
Each part of the new dressing comes in a sterile package that is now waste and has to be carefully disposed of. As an aside, much of the waste has my name and birthdate on it and each time that happens, it has to be disposed of differently so that my name doesn’t end up in the garbage where somebody could see it. End aside. Then the new dressing, including a jell-packet of disinfectant, is put on to cover the entry point of the PICC.
Lastly, the new dressing is dated. Then, probably for the second or third time, the nurse asks me my name and birhdate and gives me my daily charge of daptomycin. I have no idea what all this costs, somebody once said that the daptomycin, alone, is $110.00 and it comes with its own – wrapped in a sterile covering, of course – connecting line and two syringes to flush the PICC line before and after the dose.
Then I am happily on my way, back into the world.