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Old 05-02-12, 07:07 AM   #1
qcpmsame 
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Infusion antibiotics again, need some input. Warning, long

I have an MRSA infection from a surgery in 2006, it flares up regularly and is usually stopped with a round of Cipro. For the 4th time It is overtaking this Rx and I have to go through a round of infusion antibiotics again. A P.I.C.C. line is installed in the left arm, inside the bicep for daily hook up to the IV. I've had 4 different infusion lines and more P.I.C.C. lines than I can remember since 2000. Not a big thing but the keeping it clean and dry is paramount (no bicycle pun intended) so the wrapping with saran wrap for showers is old hat for me.

They have to walk a fine line on killing this bacteria and not making me resistant to the really strong antibiotics. (Usually vancomyicin, sp.)

The line runs direct to the heart so you cannot play around with infiltration or contamination. Any ideas on how to safely wrap the line at its entry port so I can ride and protect the line properly? The infusion center and the infectious disease doctor just say wrap it and keep it dry. I figure they do not want the liability of recommending a method for bicycling. The don't stop physical activity, per se, but I ask about all my doings so I can keep this monster at bay and not be a part of the problem.

If you have any method for wrapping or what to use please chime in. Flames aren't wanted but I'll take them with the good advice here.

Bill
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Old 05-02-12, 02:03 PM   #2
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I'm not sure exactly what you're asking. Are you asking how to keep the site dry even if you get sweaty? I'm wondering about laying down some vet wrap on the arm skin, then placing the port on it, placing clean gauze on that, and then laying another layer of vet wrap down. You would change the whole thing the moment you stopped the activity. Cleaning the skin with isopropyl alcohol before and after would also be a good idea.

Mind you, this is just a guess as I've never actually done it before.
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Old 05-02-12, 02:13 PM   #3
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Bill,

Try some of the medical supply houses in Pennsicola and see what they carry in foam IV retainers. They are foam tape patches that usually have clear tape centers and they come in various shapes and sizes. We used them to secure IV catheters to the patient. They'll keep dirt and moisture away from your port, if that is what you asking about.
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Old 05-02-12, 08:08 PM   #4
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Bill,

Try some of the medical supply houses in Pennsicola and see what they carry in foam IV retainers. They are foam tape patches that usually have clear tape centers and they come in various shapes and sizes. We used them to secure IV catheters to the patient. They'll keep dirt and moisture away from your port, if that is what you asking about.
What he said.
A variety of different breathable dressings specifically for central line protection/retention are on the market. In a hospital setting especially, it's important to make sure the site dressing stays intact.
Are you looking for ideas on how best to protect the site dressing?
Basic strategies: Wrap the area with kerlix or similar gauze. Or, cover the site with a gauze pad held in place by elastic netting (Surginet, Elastinet). Replace after riding. Replace the site dressing, also, if it is not intact.
How are you at one-handed dressing changing? Pretty good, I bet, if you've been dealing with PICCs for a long time.
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Old 05-03-12, 05:40 AM   #5
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I was asking about how best to keep the area clean and dry while I ride. Y'all are on the right track. John, that is basically what I am thinking of, the hospital uses this guard in there for my I.V.'s. I'll check with the medical supply house I use for materials and see if they have some.

Jan, I am really good at one handed dressing changes, now. After 12 years I can actually do a dressing change and cleaning of the abdominal wound that stays open in the dark at 0500 in the morning. I think a guard like John mentioned and the wrap of kerlix as Jan said over this to keep everything snug will work. Dudelsack, I clean and change the dressings after every ride and at least twice during the day so you are dead on with your advice. Thanks to Dudelsack, John and Jan for the input.

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Old 05-03-12, 12:37 PM   #6
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I thought MRSA was just a UK problem but apparantly not. Hope you can deal with the problem you are now having and able to keep riding while undergoing treatment.
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Old 05-03-12, 01:01 PM   #7
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One of the doctors in a practice I go to had(has?) MRSA and had a portion of his heel removed a few years ago. I just found out recently, from what I read in the letter to patients at the door, he had his foot amputated in April because of MRSA. I believe, after his recovery and rehab, he'll be back practicing in the office by the end of this month, May. I saw him at the beginning of March because my doc didn't have any openings and he seemed fine and related such--he made sure that he used hand sanitizer before starting the visit and used sanitizer on himself and gave some for me to use after the visit.
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Old 05-06-12, 04:55 PM   #8
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Do you use a "Biopatch" at the insertion site? If not, it might be something to consider:



http://www.ethicon360.com/products/e...patch-products
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Old 05-06-12, 05:59 PM   #9
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I thought MRSA was just a UK problem but apparantly not. Hope you can deal with the problem you are now having and able to keep riding while undergoing treatment.
Sadly, about 50% of staph infections in the US are from MRSA.
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Old 05-06-12, 06:47 PM   #10
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Not so long ago, you had to be hospitalized to risk catching MRSA.
Community-acquired MRSA is becoming more and more of a problem.
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Old 05-07-12, 05:34 AM   #11
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Mine is hospital acquired MRSA and a few other nasty things thrown in this time. Got it in 2006 during a surgeries and had to have all the infected tissue and the support mesh removed late that year. Comes up often and now is a particularly bad time.

Bill
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Old 05-10-12, 06:04 AM   #12
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All a moot point since the doctor and infusion center said no physical activity that will allow sweat to get into the entry point for the catheter. Then the doctor put me on Zosin which requires wearing a pump for 2 weeks since it must be infused every 6 hours around the clock. Pumps and riding don't work well for me so walks with my wife will make do for now.

This infectious disease doctor is fired when the antibiotics run their course. I told him no pump, use something that doesn't require one. He agreed then turned around and ordered a pump when I left his office. Too late now since the PICC line is in and the antibiotics have begun, but he is gone, I'll inform him when I go back. His manner rubs me anyway and Pensacola has plenty infectious disease specialist.
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Old 05-10-12, 06:38 AM   #13
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This infectious disease doctor is fired when the antibiotics run their course. I told him no pump, use something that doesn't require one. He agreed then turned around and ordered a pump when I left his office. Too late now since the PICC line is in and the antibiotics have begun, but he is gone, I'll inform him when I go back. His manner rubs me anyway and Pensacola has plenty infectious disease specialist.
The nickname for infectious diseases as a specially is Obnoxious Diseases. I don't know why so many of them have such big chips on their shoulders, especially now that vastly improved informatics may soon make them all obsolete.
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Old 05-10-12, 09:06 AM   #14
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All a moot point since the doctor and infusion center said no physical activity that will allow sweat to get into the entry point for the catheter. Then the doctor put me on Zosin which requires wearing a pump for 2 weeks since it must be infused every 6 hours around the clock. Pumps and riding don't work well for me so walks with my wife will make do for now.

This infectious disease doctor is fired when the antibiotics run their course. I told him no pump, use something that doesn't require one. He agreed then turned around and ordered a pump when I left his office. Too late now since the PICC line is in and the antibiotics have begun, but he is gone, I'll inform him when I go back. His manner rubs me anyway and Pensacola has plenty infectious disease specialist.
FWIW, there have been studies showing that 4 hour infusions of Zosyn are more effective at controlling infections than the traditional 30 minute to one hour infusion times at the same dose. I suspect this is why your ID doctor insisted on a pump.
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Old 05-10-12, 01:51 PM   #15
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John,
I'm sure you are correct and if the I.D. physician would have discussed this with me or called me to tell me what he had decided it would be different. The infusion center called his office and he told the nurse he didn't care what I thought and it was 2 weeks to start so just live with it. The infusion center had 3 nurses there in case I lost it since their team leader told me what he said. No need in ever fussing at a nurse, they do what the orders say and try to make the patient comfortable and safe and I know every one of there professionals from previous care, they are the best. I know MRSA is a forever thing. Known that since 2006 when I contracted it.

I do appreciate your info and input, he has me on 30 minute infusions from the pump every 6 hours around the clock, no charge for the nausea and vomiting. He didn't use the 4 hour infusion I had those with another antibiotic a few years ago in hospital. Last spring it was vancomyicin with 2 infusions of 1-1/2 hour 12 hours apart. I just really hate the pumps and wearing them after having to wear one on 2010 for 6 months 24 hours a day for TPN. Thanks anyway, and I'll remember your info.

Actually, I just want to ride with the beautiful weather we are having. It is driving me crazy.

Bill
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Old 05-10-12, 04:15 PM   #16
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I know MRSA is a forever thing.
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Old 05-10-12, 06:01 PM   #17
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Are you receiving Zosyn or Zyvox? If you are receiving Zosyn, did the Dr perform a susceptibility test. Zosyn is not generally effective for MRSA. By definition MRSA is methicilllin resistant Staph aureus. Copied this info from a drug reference for Zosyn "Activity in vitro and in vivo:Aerobic and facultative gram-positive microorganisms
  • S. aureus (excluding methicillin- and oxacillin-resistant isolates).[SUP]1 [/SUP][SUP]2"[/SUP]



Note the excluding.
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Old 05-10-12, 07:48 PM   #18
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John,
I'm sure you are correct and if the I.D. physician would have discussed this with me or called me to tell me what he had decided it would be different. The infusion center called his office and he told the nurse he didn't care what I thought and it was 2 weeks to start so just live with it. The infusion center had 3 nurses there in case I lost it since their team leader told me what he said. No need in ever fussing at a nurse, they do what the orders say and try to make the patient comfortable and safe and I know every one of there professionals from previous care, they are the best. I know MRSA is a forever thing. Known that since 2006 when I contracted it.

I do appreciate your info and input, he has me on 30 minute infusions from the pump every 6 hours around the clock, no charge for the nausea and vomiting. He didn't use the 4 hour infusion I had those with another antibiotic a few years ago in hospital. Last spring it was vancomyicin with 2 infusions of 1-1/2 hour 12 hours apart. I just really hate the pumps and wearing them after having to wear one on 2010 for 6 months 24 hours a day for TPN. Thanks anyway, and I'll remember your info.

Actually, I just want to ride with the beautiful weather we are having. It is driving me crazy.

Bill
Sounds as if your ID doc is not big into communication. That's not a good thing.

Nice of you to say good things about the infusion nurses, this being National Nurses Week 2012!
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Old 05-14-12, 07:12 AM   #19
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Jan,
I took all the Infusion Center nurses lunch on Wednesday. A big box of turkey sandwiches and a big box of grilled chicken breast wraps. My wife and I are big time nurse supporters since I have had the 3 back and 13 ab surgeries since 2000. These professionals are the greatest asset a hospital and doctor has. This is my 2nd antibiotics Infusion in a year. They took care of my PICC line in 2010 when I was on TPN for 6 months with ab/intestinal fistulas. In all my hospitalizations I had only 2 nurses that rubbed me the wrong way but I kept my mouth shut and just discussed my problems with them privately.

Hunter, I am old friends with MRSA, got it in 2006 in a surgery, not sure why the change but I doubt 2 weeks of this is going to work and I don't doubt you one bit. The drainage is just as bad as ever. A new I.D. doc can straighten this out after next Monday.

Bill
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