Hospital – 5 April 2007

Well, in a welcome surprise, I’m being discharged today. Apparently I can take oral antibiotics, so that is a good thing! I am armed with two cans of vanilla flavoured Sustagen (no more foul Ensure Plus – hooray!), and from what I could see of my drug order, I will have a shopping bag full of drugs to keep me from harm’s way. I need to keep away from sources of infection, as my blood counts are low-low-low, but all seems to be well otherwise. Yay! I can sleep in my own bed again! No more 2am observation rounds (until I return to hospital in only 11 days time). I will need to come back to the hospital next week for a review, rituximab, and the insertion of a new PICC, but otherwise I’ll be somewhat free.

The sobering truth is that I most likely caused my infections through sloppy attention to protecting myself. It has been a hard (and for the tax-payer expensive) truth. I had underestimated my vulnerability and the importance of keeping myself safe, and overestimated my precautions. I now know that I can’t risk anything at all. This is particularly important, because following the cycle I’ve just been through I am at even greater risk. My blood counts will dip down for the next few days. I have an injection of PEG-filgrafin before I go home, which is designed to stimulate them higher. It has a seven-day duration of effect, and is doubtless outrageously expensive.

Expense is something that I have been thinking about from time-to-time. The cost of this treatment must be very high. The chemo drugs themselves are not that expensive, barring the rituximab, as they’re all generics. The add on supportive pharmaceuticals, pathology, medical and nursing care, dietary support, and so on are the expensive bit. I feel very grateful that I live in Australia, and through our universal public health system (Medicare) can get treatment every bit as good as that enjoyed by the wealthiest in our community in the best private hospital. The only area in which my care might be considered to be poorer or different is in the bed accommodation and food services (hotel services) areas. And I don’t care about those. Anyway – expense. Is the expense of getting me better worth it for the taxpayer? Is it fair to expect that it would be? Should we make decisions based on such a criteria?

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