"Nuke the site from orbit. It's the only way to be sure."

After just over one year of treatment, including seven months of IM Bicillin and one month of triple antibiotics--I've only improved a little. My energy level is about the same as when I started treatment. My cognitive/neuro symptoms are a little better. So it's time to break out the big gun.

I'm going to start IV Rocephin (ceftriaxone).

Once I start the IV Rocephin, I'm going to discontinue the IM Bicillin. I will continue taking Biaxin, and I'm switching back to Flagyl from Diflucan. I'll be hitting all three forms of the bacteria, and I'm hitting hard.

This means that I'm going to have a PICC (peripherally inserted central catheter) line installed. It'll run from my arm, through a vein, and empty out just above my heart. I'll be taking 2 grams Rocephin once a day. This may increase to 2 grams twice a day, on a pulsing schedule--four days on, three days off. We'll see how it goes.

An infusion service is going to set up the first month of medication for me. Once a week, a nurse will come to the house to change the dressing on the PICC line. Nick will also learn how to change the dressing, since it's unlikely that our insurance will pay for more than a month of the nursing service (if it'll pay at all). We'll also have to figure out where we'll be getting the medication and supplies if/when the nursing service stops coming by.

My life will be a little more restricted. No getting the insertion site wet. No carrying heavy stuff with that arm. Try not to get sweaty. I'll have to take Actigall as a preventative measure against gall stones (a known side effect of Rocephin), and I'll need monthly blood tests to monitor kidney and liver function.

I don't know when I'll get the PICC put in. My doctor's office has to call the infusion service, who has to call my insurance company. Then I need to call the infusion service, or maybe they'll call me...I'm not sure. Then after the infusion service is set up, I have to schedule the actual PICC insertion. Then I have to tell the infusion service when the PICC will go in, and schedule their first visit for the day after the insertion. And then I actually have the procedure and start taking the IV medication. At least I think that's the order of things.

And we hope that the medication works and I start to get better.

In the meantime, I'm going to have Fry Laboratories do a blood smear test for bartonella. I've done the standard treatment for bartonella, but that doesn't mean we are completely sure it's 100% gone and isn't a factor in my slow recovery.

There are no promises in Lyme treatment. So I'll just see how it goes.