Cooties to the nth degree

When the culture from Namine’s open chest incision first came back as positive for MRSA, she was put in what the hospital called “contact isolation” (as opposed to vanilla isolation). That meant that all hospital personnel coming into Namine’s room were required to don disposable gloves and gown. We, her immediate family, were not required to do so on the general care floor. The thought process there was that if she had MRSA – which of course she did – then we were carrying it too. (To clarify, that’s to say that we were, or perhaps are, colonized, not to be confused with infected.)

When Namine was brought down to the cardiac ICU after the wound vac placement, she was in vanilla isolation: even immediate family members, potentially colonized or not, were required to gown and glove up. When Namine was moved back up to the general care floor again, that restriction was lifted; we were no longer required to gown up, while hospital personnel still were.

Having been sent home, of course, there is absolutely no way to maintain a sterile environment. (I think it’s debatable whether a true sterile environment is feasible even in the ICU rooms, but that’s a topic for another day.) The best we can do is wash and sanitize our hands a lot.

But our hands are not the only thing we need to keep as clean as possible. With the threat of MRSA, we have to clean everything Namine touches. That means her bedding must be changed and washed every day; hard toys (like My Little Ponies, blocks, the toy house and its inhabitants) must be wiped down every night (even if Namine only plays with one toy and throws it back in the box, each one in the box must be cleaned); and her laundry must remain separate and not touch any of ours, even after coming out of the dryer (this includes towels and washcloths). This makes for a slightly exhausting night.

Even though we’re not required to maintain a sterile field for Namine’s vanco dose (as we were with trach cares), we still have to make sure that the line remains as clean as possible. You’ll recall that while she was in the hospital, she had a PICC line placed. That central line (quite literally a line to her heart, no small matter that) is necessary for her to receive the vancomycin, which can only be administered intravenously. Namine was doing well enough to be sent home (obviously), but she still needs to be on the vanco until next Monday. As a result, she needs home medication.

Whenever Namine received her vanco at the hospital, she was attached to a pump on a medicine tree. This was nearly identical to when Namine received her g-tube feed from the feeding pump – medicine tree and all. Naturally, we assumed that she would require something similar at home for the vanco treatment. Fortunately, this was not the case. Enter: the vancoball.

This little package contains one dose of vancomycin, delivered via a self-contained high pressure system. It takes about forty-five minutes to complete. Since it’s portable, we put it in a little purse for Namine to carry around; this way, she can continue to play and scoot around the apartment and still receive her medication. (One of her greatest frustrations was being stuck in bed while receiving the medicine; fortunately, that need not be the case at home.)

Namine receives one dose every six hours, and while they need to be refrigerated for the long term, once unrefrigerated, they still keep for six hours. This means that requiring her vanco dose will not prohibit clinic or therapy visits (once she is cleared for visits, at any rate; being MRSA-positive, she’s not yet permitted to return to therapy).