PICC Me a Winner! and Make Love, Not Warfarin!

The good news is, I'm going home this afternoon! The not-as-good-but-could-be-a-lot-worse news is, I had to get a PICC line.

PICC stands for Peripherally Inserted Ca-Ca (or Central Catheter, but whatever). This morning, Sharon and Viviana, PICCers extraordinaire, waltzed into my room with their handy-dandy ultrasound. They sonogrammed my right upper arm and picked a vein, painted me with blue antiseptic (making me look a bit like a Pict), and poked me to place a PICC.

Afterwards, I was disappointed to learn that I got a down-market PICC. Did I get a triple lumen (the lumen is the hollow part of any tube) or even a double lumen? No! I got just one lumen! And did I get a "Power-PICC"? No. I don't know what a Power-PICC is, but I deserve one! On the bright side, mine is 42 cm long.

So, you may be asking, why PICC me? Because I'm getting at least 6 weeks of home IV antibiotics. I have a whole garden of bugs growing out of that booger. We won't know what the main problem was until the bone sample has soaked in the special blend of herbs and spices for a week or two. The leading candidate, at this point, is good-old radiation necrosis with a heap of bacteria on top. Disgusting never sounded so good. There is still a small chance that they will find a cancer at the center of this thing, but I will ignore that possibility for now.

A little digression on warfarin (a.k.a. Coumadin, a.k.a. rat poison--that's not a joke)

I was interested to find out from a friend in the neurology mafia that giant mutant boogers (a.k.a. skull-base osteomyelitis) may cause the same kind of stroke I had. For this, and other reasons, my excellent primary care doc (henceforth to be known as Dr. Mr. Whipple, because he resembles Mr. Whipple) does not want to put me on warfarin. I cannot tell you how happy this makes me.

Warfarin is one of the oldest drugs in the pharmacy. It is, in fact, rat poison. If you lace rat chow with warfarin, the rats will bleed to death. However, at lower concentrations, it is an incredibly useful drug and has save hundreds of thousands, if not millions of lives. But it is also a giant pain in the hiney. It interacts with all sorts of foods and drugs. You need blood tests every week to month to make sure the dose doesn't need adjusting. There is always the lurking danger of a catastrophic bleed. Nevertheless, if you have had a pulmonary embolus, deep vein thrombosis, or certain kinds of stroke, there is no substitute. There are some substitutes just coming on line for people with strokes from atrial fibrillation, but I am not even sure they are as great as their publicity.

So, if Dr. Mr. Whipple, in consultation with some of the best stroke folks in the business, had said, Tumoriffic Tom, you need warfarin, I would have taken it. But he didn't. I'll just be on aspirin. (Unless there is another stroke, but we'll cross that bridge. . .)