About to start IV clindamycin – urgent questions

[jfr]

I am supposed to start IV clindy next week, 900mg twice a day. My kids will finally all be away at camp and I will have 2 weeks to work on my health without interruption. My doc here has spoken with Dr. S and got the IV protocol. However, he is having me do it with only about 4-5 hours between IVs due to his office hours (10:30-6pm, so I need to get an IV at 10:30 and again at 4:30) and I am nervous about this. I've read there should be at least 6 hours between Tx and given that i am petite (110 lbs) I am concerned about not taking enough time between the IVs or overdosing. I'm set to have 2 IVs a day for 5 days. Would I be better off doing it once a day for 10 days under these circumstances? And would taking off the weekend, as I would be forced to do, cause a problem?

I have not been on any Minocin yet and am starting the protocol with the IVs.

Any advice would be appreciated.

[Kim]

I would run this past Dr. S.  If it's only a matter of scheduling, I've heard of doctors arranging for a home healthcare nurse to come to your home and do the IVs.  Could this be a possibility for you?

Good luck…….you're on the right track.    kim

[kat]

The 6 hours is from START to START. So 10:30 to 4:30 is 6 hours apart. That should work just fine. 🙂

Home health care is also an option, but a much more expensive one.

[A Friend]

[user=40]Kim[/user] wrote:

I would run this past Dr. S.  If it's only a matter of scheduling, I've heard of doctors arranging for a home healthcare nurse to come to your home and do the IVs.  Could this be a possibility for you? 
Good luck…….you're on the right track.    kim

JFR,

Adding to Kim's suggestion about a home healthcare agency, I've read posts before that this “can be” a good way to do the IVs, and it was said that the prescription they received for the IV solution was gotten from Wal-Mart or such pharmacy, and the charge for the heathcare technician plus the RX IV drug proved to be cost efficient.  This is not a recommendation, but just more possible things to look into and consider. 

It is good that your local physician was willing to work with Dr. S and they are working together.  Also, if you'd ever like to talk directly with Dr. S in Ia., don't hesitate to call him, as he is very compassionate and is happy to talk with patients, even if they are not his own.  

Good luck to you,

AF 

[kat]

I should have mentioned that I am in Ida Grove RIGHT NOW and was told just last night that the 6 hours are indeed from START time to START time. So I will repeat myself that 10:30 and 4:30 would be the required 6 hours apart. Certainly it might be slightly better to have them a bit more apart, but if that's the best you can do, I would not hesitate to go for it.

I compared costs before coming here. Insurance might cover my visit here but it definitely would not have covered home health without a local AP doc willing to code it as infection (good luck ever getting a rheum or GP to code it as infection) and even then it is doubtful insurance would have paid (and we have a pretty decent insurance plan). But even if my insurance does not cover the treatment here, it was cheaper to drive and get treatment here in Ida Grove then it was to pay the high cost of home health. Certainly your situation may be different.

[jfr]

Wow, I feel so much better now that you're telling me the time is from start to start. I would love to call Dr. S myself and it's great to hear that he will speak to me. I'm pretty sure I have his contact info.

I live in San Diego and my doc runs a holistic practice and is very willing to help patients do what they want to do. He kind of depends on us to do the research, though, so I needed to be sure that what he was proposing was safe. Sounds like it is. He is charging me $150 per IV, which sounds pretty reasonable to me, and I might be able to get insurance to pay but I will have to bill them myself. I'm sure he'll code it correctly. How much does it cost to get these tx in Ida Grove? Or with home health care? I would prefer to be in a doctor's office while this is going on and it's all set, so I don't think I'll be changing my plans at this point.

I did run across one article that gave me pause, though. If any of you wonderful people are so inclined, take a look at this and let me know what you think. It's about large doses of clindy and a big problem that can occur:

http://www.cja-jca.org/cgi/reprint/42/7/614.pdf

Thanks,

Judy

[kat]

I don't know if this is true or not, but I was told that Dr S no longer takes calls from non patients. I would be interested to here if this is correct, or not.

The approximate costs in Ida Grove are around $3000-$3500 (plus transportation, lodging etc). Home health care is over twice that much, at least in my area. In Ida Grove you are in the IV center of the ER part of the hospital.

If I need them again and could get them at home for $150 a piece, I'd certainly go that route, that's a good deal IMO.

Re the article: sounds like that lady had quite a large dose all at once. Anything in too high of doses could mess you up.

[jfr]

One more question. My doc plans to do a heparin lock instead of sticking me so many times. He says I'd need a new one every two days. Does that sound good to those of you with experience? Is there a better way to do this that doesn't involve walking around with that thing? I can imagine it would be uncomfortable to sleep with.

To be clear, they do lots of IVs at this office but this is the first time they are ever doing an antibiotic protocol like this for RA. My sense is they usually have patients who come in every week or so for something.

Thanks,

Judy

[MaryP]

I don't find the heplock very uncomfortable and I just hate all that stuff.  Granted, it's not something I'd like everyday, but it was doable for a few days.  I needed a new lock after my 8th IV the first time, and my 6th IV the second time.  It just depends on your veins, and your doc or nurses.  Don't forget not to get it wet.

I had the area where the lock was located, wrapped in between IVs, which helped me with the ewwwww factor.

Good luck!

[kat]

Being as how they are used to giving IVs, I'd be comfortable with whatever they choose for you.

I had to have my IV lock taken out after just 2 treatments here and have opted to have a new stick each time…… for as long as my veins hold out and then will have to go back to a lock. But here, they will keep you in the lock for the full 5 days if it lasts that long, so changing every 2 days is not at all out of line. They wrap them up very well so that they really arent a problem, except for like Mary said, keeping it dry in between changes.

Mine was removed because it hurt so much and I knew I would not be able to sleep. But I have had them before that did not hurt at all, so if I were you I'd just get the first one and see how it goes. If you have any problems just tell them and I am sure they will work with you. You have all day the first day to see how its going to feel and time to let them know at the end of the day if you are in too much pain.

[JBJBJB]

[user=324]jfr[/user] wrote:

My doc plans to do a heparin lock instead of sticking me so many times.

Judy,

When I was in Ida Grove, I had the heplock. It could only last for 3 IVs. I got some infection on my IV site. The nurses tried to rotate the site. I found when the lock was placed on my lower arms, it helped me. I would not let them do it on my hands.  

[jfr]

Thanks to everyone for the great advice. Sounds like I will have to play it by ear vis a vis the heplock. I do wonder, what if they take longer to hook me up at first and that means I have, say, 5 hours between IVs on a given day? Kat, I'm wondering if you could ask next time you're in the IV clinic, since it sounds like you're in the thick of it right now. I would imagine they would know the answer. I know that in my doc's office they do not always start things on time, so I do worry about having them too close together.

Also, did any of you restrict your diets while on IV treatment? I've heard about avoiding sugar, but would prefer to eat normally if I can. I would hate to give up my daily soy chai latte! Did you have to make dietary changes for the treatment to work right?

I can't tell you how grateful I am for all these replies. I was in high anxiety last night when I sent my first email and now feel confident I will know what's going on by the time I start treatment next week. Thanks to all of you!

[Kim]

Hey Judy,

Another thought with the IVs.  My lock irritated my veins too much  so and they had to do a butterfly each time in a different place as others have mentioned.  I also learned that I could not tolerate the 'normal' flow rate.  Those with good veins (definitely not me) were in and out in about 20 minutes, but they had to put mine on a pump to slow it down and it took about an hour.  Any way you can get the stuff in you :doh:.

Good luck…..kim

[Goodwife]

jfr,

Hi – my hubby's doc also consulted w/dr. S and did the 6 hour start to start schedule.  His was 8:30 a.m. then 2:30 – Because of our doc's IV schedule, my hubby did the IVs Wed-Thurs-Fri and then Mon-Tue of the following week – not our choice, but it still worked out fine.  kept the heplock in for the W-F days and removed, and a new one M-T.  Even if you wanted to do the 1 day for 10 days, you could.  The medicine is still getting in to you, and will do its thing no matter what schedule  you can work out.  Good luck!

 

 

[kat]

[user=266]JBJBJB[/user] wrote:

When I was in Ida Grove, I had the heparin lock.

I am not sure when they started doing it, but Horn Hospital  here in Ida Grove no longer does hep locks. They are just IV locks with saline.

I have pretty bad veins but have had no problems with the full drip, in and out in about 20 minutes. I feel a bit “heavy” while its going in but nothing I can't stand.

[Author]

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