The Cough: Waging war

These events happened between 1997 and 1999. My health is currently pretty good.

After dumping my first pulmonologist and basically just ignoring my first ENT doc, I found new hope in my infectious diseases specialist. A lovely woman, first generation Cuban-American, who seemed genuinely concerned and competent. This wasn't to last throughout my relationship with her but she did me a great amount of good. I always pictured her as driving a black Porche Carrera and was disappointed to learn she drove a fairly low key BMW sedan. She is the one who introduced me to the PICC line and that is when I began the long road to recovery. I was to go through two, this covers the first.

She arranged to have the PICC line inserted by a couple of nurses at a nearby (to her office) hospital. A simple process quickly accomplished. I was introduced to the procedure of connecting/disconnecting the antibiotic container, clearing and cleaning of the connector using Heparin and care of the insertion point (preventing infection), and living with a tube hanging out of my left arm. It also meant showering with my left arm wrapped in plastic for the next several weeks.

The antibiotic was delivered in what looked like medium sized cold cream jars. These were to be kept refrigerated until about 15 minutes before use. Inside the jars, there was a balloon which filled it. Inside that balloon was the antibiotic. The balloon would "deflate" as the antibiotic was delivered through the line. The process took about 20 minutes or so from taking the jar from the fridge. If all went well. If there was no blockage in the line. Each week, a van came to our house and delivered a Styrofoam cooler filed with the next week's doses packed in those frozen gel packs and would pick up the empties. (We kept a number of those gel packs, very handy things, and at least one Styrofoam cooler.) The second PICC line, I was giving syringes (sans needles) which were much easier.

I had to do the treatment 3 times a day. Once every 8 hours. Even if I had to get up at 3 in the morning on my days off. I was working midnight to 8 AM at the time and I set a schedule of 11 (or so) AM, 7 (or so) PM, and 3 (or so) AM.

The first day after insertion of the PICC line, I ended up in the emergency room. The cough had me whipped that day. My lungs were clogged and I could not make it to the hospital on my own (Faye was at work) so I had to call 911. They arrived in a big rescue truck, ignored the PICC line and jabbed another IV into my right arm to provide me with the usual saline and off we went. 5 hours later, I was home again and breathing better.

The only other incident was a visit to the ER because the PICC line coupling blocked. Instead of clearing the blockage, the ER nurse tried to give me the dose through a vein in my hand. I had been on prednisone for several months and my veins were easily ruptured. The idiot did not listen when I told him not to use a tourniquet and the vein blew out. I told him to find someone else to deal with me. And he eventually did (after I "insisted"). It was only one of so many times in that two year period where I noticed that medical professionals do not listen to patients.

The line was supposed to be in for a period of 8 to 12 weeks. It stayed in for 16. It helped but did not cure. We found out during the second PICC line period that the pharmacy was giving me a generic form of Fortaz and it just wasn't good enough. She had not authorized use of a generic.

Removing the PICC line was done at her office by a nurse. It's a weird feeling as the line is slowly drawn out of your arm. Dr. Diaz chatted with me while it was being done. We talked about pseudomonas and she mentioned that it could be really nasty if it got into the lungs. My response? "Hello? Why do you think I am here?"

Like I said, they just don't listen.

When I ended up back in the hospital about 7 or 8 months later and needed another PICC line, things picked up speed. I "fired" my primary doctor when he again insisted I "must have allergies" and called me "Doctor Doug" in a rather condescending and dismissive tone. I chewed him out, told him to not bother to come into my room again and to simply sign off on anything Dr. Diaz ordered. I would switch to his partner as my primary after I got out of the hospital. I was still being badgered to have sinus surgery, which I still refused to do because no one could, or would, explain just what it was supposed to do in my situation. It was during that stay that I re-asserted my usual demanding self and took control of my problems and began to get better.

I have since decided that doctors are like auto mechanics. Great ones are very rare, and if you find a good one (who listens to you), hang onto him or her. And I hold the philosophy of this: a doctor who makes a mistake may only lose a bit of income, the patient may lose a lot more.