A PATIENT’S STORY

Becky Burns is an Island person.

As a child she would spend the school year in Seattle, but the day it let out, she and her family would go to their summer place on Orcas Island. There they could run wild and enjoy the unique freedoms that only Orcas could provide.

Orcas would be the first of many islands that Becky would inhabit during her life. At one point in her early twenties, she lived on a 3.5 acre island just off the coast of Orcas. She had no running water, no electricity, and no neighbors. It was just her and her gardens, a clean simple lifestyle that she would pursue throughout her life.

But Becky does have an entrepreneurial spirit, and eventually she earned enough money selling cakes ($1 profit!) that she got a ticket to Hawaii, ultimately settling in the Anahola Valley on the island of Kauai. There she started baking granola, and some forty years later, that is what she continues to do. If you have been to Hawaii, you have probably run across her awesome product; Anahola Granola is widely distributed throughout the islands from their bakery in Anahola.

In June of this year, Becky took a trip to Africa, and upon return noticed a pain in her stomach. Thinking she had picked up a parasite while swimming, she consulted her local healthcare provider for confirmation. Unfortunately, her self-diagnosis was incorrect; Becky instead was feeling the first symptoms of Non-Hodgkins Lymphoma. She took swift and immediate action, and began a chemotherapy regiment at a well-known cancer center in Seattle. They came up with a plan for her to receive 6 R-CHOP chemotherapy sessions through a PICC line, each 21 days apart. Indicative of her spirit, Becky chose to embrace the chemotherapy entering her body, thinking of it like sunlight glinting off the surface of water. Quite island-esque.

She travels to Seattle to receive these R-CHOP infusions, and in between Becky was in need of weekly dressing changes on her PICC site. Since Becky is now 65 and a Medicare beneficiary, the only place she could go locally to get that done was the hospital. Unfortunately, after a couple of dressing changes, Becky noticed bumps and blisters on her skin, and her arm was itchy and raw which kept her up at night. The sutures that held the PICC line in place then began to pus, and Becky was admitted into the hospital to receive IV antibiotics to combat this newly acquired infection. This was literally the first time she had any sort of antibiotic therapy in her life.

The last thing that a person battling cancer needs is to be admitted to the hospital with an infection on their PICC site. Oncology patients are under heavy medical loads and as a result of chemotherapy their immune systems are often suppressed, making them quite vulnerable to other health-care acquired infections. Fortunately she avoided that further complication; they pulled the PICC line, put in a new one, and she was on her way.

After her discharge Becky decided to take a different course, so when the next dressing change was due she showed up at our facility to get it done. She came to Infusion Solutions despite having to pay 100% out of pocket due to Medicare’s lack of coverage for home infusion services. And it was here that a remarkable discovery was made by one of our infusion nurses—Becky was allergic to the chloraprep cleansing solution that is commonly used on PICC sites. We began using a simple iodine and alcohol-based option instead, and in time her issues with the PICC site resolved completely!
Our nurses took the time to figure out the one simple thing that had been overlooked by all of her other providers, and for that Becky is quite grateful. We shared what we discovered with her oncology team down in Seattle, so their dressing changes are now a non-issue as well. It is the small things that sometimes matter the most, and this small collaborative gesture went a long way towards a happier, healthier patient.

Fighting cancer is obviously a big deal. Getting a routine dressing change should not be. Medicare should cover the cost of our services for Becky, but they don’t. Instead, Medicare forced Becky to the hospital, which is the most expensive place to go. Medicare covered those unsuccessful dressing changes, the resulting hospital stay, and the placement of a new PICC line, passing that bill onto the taxpayers who support the Medicare program.

Becky is now on her last round of chemotherapy, and with any luck, she will be discharged from our service in a couple of weeks. Her prognosis is good, with an 80% survival rate. If all goes well, Becky will be cancer-free and back to her Hawaiian Island before Thanksgiving. I can’t think of anything an island girl would appreciate more.

We at Infusion Solutions are grateful to have played this small role in Becky’s recovery and we wish her the best of luck as she returns to full health. We can’t wait to see her again at her Anahola bakery next time we are on her island. Aloha!

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