Surplus, or: Fun Ways to Repurpose Medical Waste

One of the things I'm left with after this ordeal, besides a funny-looking neck and some substantial medical bills, is a collection of medical surplus. After my 'jailbreak' from the hospital nearly a month ago, I've received weekly deliveries of medical supplies to my house to assist me with my TPN and antibiotics applications. From what you've read, you might suppose the packing manifest for that sort of thing to be pretty straightforward. "OK, big bags of goopy sugar water, one week's supply. Check. A bunch of antibiotics packets. Check. What else is there?" Well, quite a lot, actually.

When I was in the hospital, 95% of my social interaction was with nurses. Every hour or two at first, and then every few hours, a nurse would come in, check my vital signs, inject me with painkillers or something to clear my IV line, and check my various support devices and bring me buckets of ice cubes. I rapidly developed a serious sense of respect for these men and women who, for very low pay, tended to my every need, no matter how basic, and managed to keep up a cheery outlook and remain supportive, no matter if I acted petulant, or if it was three o'clock in the morning and I was still up watching late night wrestling whilst in a stupor and demanding extra ice, another blanket and possibly a fresh pillow. They were very patient with me.

Naturally, I started asking questions about their jobs, what they liked most about the experience, and eventually started wondering if I had what it took to be a nurse myself. I didn't feel any particular inclination towards the job, although I liked the selflessly helping others angle, but I'm a curious person and like to know what makes others tick. Most of the nurses were happy to talk, and so I got the gist of the role from most of them. The best part was helping others, especially when the patients got better; the worst part was seeing a patient not recover, followed by the frustration of dealing with excessively demanding patients or doctors.

By the end of my stay, I considered what I'd learned, and decided that nursing would not be the profession for me. Not because I lacked in patience or empathy (some of you who know me can stop laughing now, thank you), or because I was especially squeamish around gross physicality. Rather, there was one fundamental reason why I'd not last in the profession very long, and this is it:

I'm a big slob.

Well, I'm not as big of a slob as I was in college, or immediately thereafter. These days, I have a cleaning service so I don't have to worry about the issue at all - it's like being able to hire a substitute mom to come by and pick up your clothes and dust off the mantle. Actually, I'm reasonably tidy for a bachelor living in a cheap apartment in a squalid section of DC, but I think I'd need at least a day, possibly a whole weekend, to clean up my place if I were expecting reputable company. I don't have a particular aversion to leaving a couple empty soda cans out on my desk if I've been busy, and my cat has been known to strew socks and cat toys and bits of yesterday's newspaper all over the floor, and I have been known to not bother to pick any of that up until several weeks has passed and I'm starting to notice that I no longer have room for a new soda can on my desktop, but nonetheless I don't think I'm embarrassingly lax about my housekeeping tendencies.

The point of this whole conversational roundabout is that I was thoroughly unprepared for the actual responsibilities involved in taking care of myself after my excuse from the hospital. "I can't wait to get out of this sterile environment," I moaned to myself. In retrospect, that should have been a worrying sentiment, considering that I was about to take my medical care into my own hands. "This'll be simple," my line of thinking continued, as I lay in bed hours before my release. "They just come in and change a bag of medicine every couple hours, I have all the lines in me already, I'll just plug in the antibiotics and other stuff and it'll be a cinch. I can't wait to get out and see all of my friends and go to the movies and do everything I'd normally do, and I'm sure everything I need will fit in a small backpack."

Well, of course it turned out to be much more involved than that. My first delivery of medical supplies came in a box that would have housed a modest refrigerator. Surprised, I lugged the box up two flights of stairs (my first mistake that weekend), and opened it up to see exactly why they'd used such a huge box for a couple of packs of TPN fluid and saline solution.

"Well, this is interesting...", I thought. I pulled out a yellow sheet - the delivery manifest. On it was written line items like this:

• TPN fluid, one day's supply - x7
• Ampicillin/Sulbactam (Unacyn) - x30
• Dosi-Flo IV tubing - x7
• TPN tubing - x7
• Alcohol wipes - x200
• Saline flush injectors - x50
• Heparin injectors - x50
• Multivitamin additive - x7
• Syringes & needles - x10
  
• End tubes - x10
• Sterile gauze bandages - x30
• C cell batteries (for the TPN pumps) - x20
• Rubber gloves - x500
  

...and so forth. The list went on, and I started rummaging around in the box, matching objects to list items. Although we'd reviewed the procedure for changing out the IV lines and using the TPN pumps at the outpatient facility on the day I departed the hospital, I was sure that there were at least a few items in this box I'd never seen before and no one had told me about. "IV prep kit? What, am I going to have to put another one of these lines inside myself", I wondered querulously as I stared at the evil-looking needle and gauze, and sanitary wipes, all neatly packaged in a small plastic kit. The effect was a little overwhelming.

As days passed, I realized that the answer was probably pretty simple: the pharmacy had simply been a little lazy. Instead of counting out exact amounts of everything I'd need, plus perhaps one or two spares of each item to account for the chance of accident, I'd been given bales of prepackaged items that met or exceeded my actual requirements. A good third of the items I'd been sent served no apparent purpose. I didn't need heparin, nor had it ever been prescribed; I was genuinely doubtful I needed ten sterile wipes just to change an IV line (I bathe daily, that should serve), and I really had to wonder why I'd been given the equivalent of do-it-yourself IV insertion kits, when I was already chock-full of needles and rubber hosing. By the end of the first week, I'd only used about two-thirds of the supplies I'd been sent. I amused myself by squirting saline solution from spare syringes at my cat when he'd attack my IV lines.

The second week, TWO giant boxes appeared. I suspected that there was a plot afoot to help me rebuild my lost muscle mass by forcing me to lift ever-increasing amounts of useless medical supplies up to my third-floor apartment, in addition to my ever-present TPN sack. As before, I had been granted a total excess of everything. My room was starting to get a little treacherous - in addition to having to navigate all of my usual junk, I had to sidestep bins full of medical supplies whilst trailing IV lines and TPN supplies, and hope my cat wouldn't elect to pounce on a vulnerable tube and cause me trip and fall over an economy-sized pack of sterile wipes.

After the second delivery, I mentioned the plenitude of supplies to my outpatient nurse, Jean. I was happy that I wasn't being shortchanged, but even though I'm not exactly known for being thrifty, I was a little concerned at the excess. She assured me that she'd mention it to the pharmacy.

Later that week, I got a call from the pharmacy. I explained the situation, and we went line-by-line over the manifest. I identified each item in turn, and stated when I felt I'd stockpiled enough to last me through the following week. The pharmacist agreed, although she expressed doubt that I really didn't need all of the sterile wipes they'd provided, and I ended the conversation with the understanding that the next delivery would only contain what I needed.

Well, that was the case. The next delivery came in a small box, and only held antibiotics and a few bags of TPN fluid (as I was going off the IV feeding regimen mid-week.) I felt a little forlorn, actually. In a way, I'd looked forward to my weekly deliveries; it was like getting the craziest collection of Christmas presents ever. Who knows what I'd receive? Wasteful as it was, I liked searching each box for the odd medical accessory that had absolutely nothing to do with my situation, and had contemplated building a mighty fort out of the manifold cardboard boxes that were now lining the wall of my apartment. I could have held the whole thing together with spare IV tubing and paste made out of powdered antibiotics and saline fluid.

Unfortunately, it looked like the mad pharmacist in charge of my case had finally managed to restrain his or herself, and I was only receiving the bare essentials of my case. I got over it, of course; I was happy to not have to move my bookshelf to accommodate another two boxes, and the week passed as I medicated and rested.

Unfortunately, the brief interlude of sanity appeared to be a passing phase. The following Wednesday, I returned home to find TWO more boxes of supplies. I wasn't even on TPN anymore, so how much could I need? Inside, the contents were all too familiar: boxes of sterile wipes and saline flushes, and packet after packet of antibiotics.

A few days later, as I recounted in my last post, I had my PICC line removed, and I was officially off the IV lines and done with my therapy. Via the outpatient clinic, I learned that the pharmacy would be discontinuing my deliveries. "Good," I thought. "I can start working on my fort now and not have to move my exercise bike to accommodate an extra wing." Returning home after my last appointment, I took stock of the leftovers.

At this point, I am left with (perhaps) 20 packets of IV antibiotics, several hundred sterile wipes, at least fifty or so saline flushes, bales of heparin (I don't even know what heparin *is*), two boxes of 500 rubber gloves apiece, a bunch of miscellaneous caps and tube fittings, at least two my-first-IV-line kits, and assorted IV tubes and flow controls. In addition, I ended up with four useless sacks of TPN fluid, which have just been sitting in the downstairs fridge aggravating my roommates who would at least prefer that if I decided to hog an entire shelf of the fridge with my food, it could be food that they could mooch and eat normally, instead of inject via a little pump and IV line.

I called the pharmacy up and asked what exactly was I supposed to do with all of this stuff. "Give it to a veterinarian or a walk in clinic," they suggested. I was taken aback. A vet, I could understand. I'm not surprised quality controls are looser for animals than they are for people. But a walk-in clinic? I've *been* to those, when I couldn't schedule an appointment with my regular doctor. Did they really take donations of antibiotics and other supplies off the streets? I recoiled at the thought. Didn't the FDA, or AMA or somebody regulate this kind of thing?

I'm still left with all of this stuff. Since the IV lines are out, I don't have cause to annoy my cat with the saline flushes. I guess I'll take everything to a local clinic, and hope that no one has a seizure because of my off-the-back-of-a-truck heparin doses.

I was particularly reluctant to dispose of the leftover TPN fluid. I sensed that it might have potency beyond sustaining human life; a lot of thought and care went into concocting this special blend of substances that was calculated to provided the maximal amount of nutrition and support that a liter-sack of fluid could provide. If I could no longer benefit from it, what could?

Well. What if I fed it to my roses?

I mean, it's sugar, water, fat, and vitamins. What living thing doesn't thrive on those things? (Note: I was a solid C student in biology in high school. Don't mock me if I'm totally off the mark on that assumption.) I was reluctant to feed it to my cat, since he's already, ahem, plush enough without concentrated doses of fat juice, and *I* wasn't interested in eating it, since I now had dumplings and sushi and peanut butter milkshakes to content myself with. It seemed a waste to put it down the sink, since a nurse had told me each daily dose cost *$200* to prepare. $200!! I had to do something with it.

There is a giant rose bush in my neglected front yard. Every month, the landlord comes by, mows the grass, picks up some trimmings, and that's the extent of our lawn care routine. Every so often, one of us gets it into his head that he's going to remake the lawn, turn it into a shining example of horticulture and beauty in an otherwise despoiled neighborhood, and the impulse lasts for exactly one weekend before we decide that it's really too hot to muck about in the dirt outside, and it would really be a lot more satisfying to go play XBox until night falls and the temperature is something bearable again.

The rose bush is always late in blooming. I can't say we've done much to help it along. Nonetheless, it struggles, and each summer a few blossoms appear, shockingly vivid against the lawn's expanse of patchy green and the brown bricks of our shared home. I don't feel like we really deserve it's beauty, but we've never done anything to prevent it from thriving, either. Except this time.

Armed with several sacks and a pair of scissors, I decided to perform an experiment upon the unsuspecting rose bush. My hypothesis: that fed a potent mixture of water, fat, sugar, multivitamins, and sunlight, my giant rose bush would thrive and bear blossoms early. This was a totally unscientific experiment, of course; there was no control group, no repetitions of the study (I only had one rose bush and a few TPN sacks), and my recollection of previous years' rose performance was the closest I had to historical data. I was pretty sure that no matter what, the rose wouldn't *die*, exactly. At worst, I guess I might choke it a little; I had no idea how plants tolerated a fatty diet. Do plants even get fat? Again, this is why I was a journalism, not a biology, major.

I spent fifteen minutes spraying white TPN fluid all over the rose bush. Neighborhood children sidled past, staring as I heaved giant clots of fat and sugar all over the lawn. I was thorough, and had several liters of material to work with; the rose bush was thoroughly coated in a slime of nutritional mix that, although it had been calibrated to my precise requirements, might also benefit a shrubbery. I do not care to brood on the implications of that statement, should my hypothesis be correct.

Two days passed. And then, one day on the way out the door to work...


"A-HAAAA!", I chortled. Two days prior, there had only been barren leaves, with a few limp buds, but now full roses blossoms were visible. Excitedly, I decided to be late for work (traffic was bad anyhow), and I stooped to examine the Frankensteinien results of my mad experiment:



"IT'S ALIVE!", I exclaimed. More than alive, in actuality; full, vibrant, saturated with color and clearly better off than the average weed or dandelion in my neglected garden. All over the rose bush, blossoms existed where none had 48 hours earlier.

I cackled as I examined all sides of the plant. The distribution of healthy roses seemed approximately even. Surprisingly, I found one rose unlike all of the others:




I don't remember having an *orange* rose. Maybe it's a mutant? Perhaps it's part Rex, part Rose, a weird hybrid saturated with enough fat and nutrients to become an exemplar of its species and something else besides. Well, before I get too far ahead of myself, it's probably just a rose. But it looks pretty good, odd color regardless.

So, my experiment appears to have been a resounding success. The rose bush bloomed early, and our lawn looks much better for it. Unfortunately, I really doubt there's anything else out there that would benefit from my medical leftovers; I don't think saline fluid, heparin, or powdered Unacyn is going to replace Miracle-Gro anytime soon.

If anyone here is a doctor or knows one, please let me know what I should do with this stuff. If it's OK to give it to a clinic, I will do that, but I am a little uncertain, particularly with regards to the prescription stuff like the antibiotics.

Well, it's time to find something to eat - preferably less fatty than what the roses had. Thanks again for reading - RL