It seems I have opened up my Pandora's box of memories, and several things have come tumbling out.
One of them is my fight for little green caps!!
I will share it here. I hope it helps someone.
I was in a hospital room in LA in February, and there they were. Little green caps! Not spending a lot of time in hospitals, most of us don't fully appreciate some of the things in that setting. I know I didn't. I learned though! Seeing those green caps again brought our life with PICC lines back to me.
When it was clear he would need ongoing administration of vancomycin to fight the infection in his blood and heart, we were told it could be done through a PICC line, at home. (PICC stands for Peripherally Inserted Central Catheter.)
I hated the thought of putting a long plastic tube into his arm and threading it up until the tip was near his heart. I believed he got the methicillin resistant staph epidermidis (MRSE) that way in the first place, through a line put into his blood stream. (Yes, I am finally writing the name, unmasking the monster that eventually killed him.)
For long term medicine delivery into the blood, there was no other way. And vancomycin has to go into the blood - it just cannot be taken by mouth. In addition, the blood levels of vancomycin need to be kept within a certain range in order to be effective. (That struggle is a story for another day!!)
The supplies were delivered by a pharmacy that specializes in PICC line drugs and the "equipment" that goes with it. They deliver directly to the home.
I learned about the little green caps from the first home health nurse we met. In the hospital, they are mandatory. However, what I found out is that the pharmacy may try to provide less than the best to you at home!!! It should not be allowed, especially when you are fighting a killer.
It is important to have a clean, sterile "tip" or port that you connect to when giving medicine, or any other reason the PICC is being accessed. After all, one is trying to fight germs, not introduce more!
In hospitals, they use the little green caps to keep the port sterile. At home, the pharmacy may try to just provide alcohol swabs - no doubt they are cheaper!
Can you believe it? Yes, maybe you can. Saying I was unhappy when I found this out would be an understatement.
I asked the nurse to just order the little green caps, and I remember distinctly what she said. "If I ask, they will tell me that the alcohol swab is sufficient. But if you call and ask, they will send it."
I called!
They had to make a special delivery, just for those green caps. I told them several times, whenever supplies were sent, that we must have the green caps. As I remember, they eventually realized I would not relent, and began automatically sending them.
Just so you know why hospitals use them, the difference they make is well proven:
Use of Disinfection Cap to Reduce Central-Line–Associated Bloodstream Infection and Blood Culture Contamination Among Hematology–Oncology Patients
Here is a page from 3M with information about them
If you are going home with a PICC line and there are unused little green caps in your hospital room, take them with you. You paid for them. And make sure the pharmacy sends them to you, every time.
Someone told me that these caps were invented by the parent of a child with infection. I have not been able to verify if that is the case or not. I am just grateful for them.
I call them "little" green caps. There really are no little things when it comes to infection. Everything matters in the fight for life.
As a reminder, these are my personal experiences and opinions, and not connected in any way to the Bicuspid Aortic Foundation.
Best wishes to all who read this,
Arlys Velebir
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