PICC Line

[kimblebee]

I have MS and get monthly IV treatments. Today was needle day and they were unable to get an IV started after 4 tries. The nurse refused to try after that because it was hurting so much and she said my veins are non existant. Even the vein that 'always' works no longer does.

I have to go back and try again next week. If that doesn't work, I have to go to the IV lab at the nearest hospital to let someone else try. If that STILL doesn't work, my Neurologist says it will be time for a PICC line.

Does anyone here have one or ever had one? I did read up on it online but of course, real people comments are always better. I'm looking for the good, the bad, and the ugly please.

 

[sonnyjane]

No experience with PICC lines but just wishing you some vibes! Due to a medical issue that surfaced a couple of years ago, I have to have blood drawn about once a month and they typically have a hard time finding my veins. It can be excruciating when they are poking and prodding in there! For me they sometimes have to switch to the butterfly needles however I'm not sure if that's an option for receiving your IV or not?

 

[mousears123]

I believe Disfan07 has a PICC line. She seems to be very informed on different aspects of medical care and traveling so you may want to try to look her up. I remember reading a thread where she was discussing traveling by airplane with a PICC line. I remember that because I had to look up what a PICC line was! Good luck OP dear.

 

[zurgswife]

As a nurse the PICC line is much better for someone who needs constant use of veins. Personally I would request that they put one in now and for go another two rounds of someone trying to stick me by hand. I've had doctors put them in place at the bedside so they aren't a major surgery at all; though some hospitals make it more of a surgical procedure.

On a personal note my dad had one and it made life a whole lot simpler. Once you get the hang of finding a way to keep the line for moving around. It tend to be made up of two lines with plastic ends that they use to access your veins; and they hang free. My dad used a clean sock with the end cut off to keep it secure.

 

[rickybobby]

A PICC line is very safe to have, it will not go bad if routinely flushed and dressing changed, and you can even have labs drawn from it.
It is inserted in the arm just like a regular IV, but the catheter itself is very long, and will run up the vein all the way to the vein just above the heart.
I have personally never seen anyone have any side effects from a PICC, but the most common one is irritation of the vein it is inserted into.
When the line is inserted, it is really no more painful than an regular IV. You do not feel it when the catheter is threaded up the arm. Usually, an x-ray will be taken to make sure it is properly seated. If it is a little off either way, it can be adjusted.
They last quite a long time if treated properly, and you seem like an ideal candidate.
A Port-a-Cath might be an option as well, but I will save explaining that for another time.

 

[ilovevacation]

Well i have never had one, but all of my patients have some sort if central line for chemo. Based on the very little i know about you, it might be worth asking your doc about an I Port. They are great because they are under the skin, in theory you still have to be "stuck" monthly, but once accessed it can stay that way for a week. They can use numbing medicine over the site to decrease the pain. The other down side is it is technically surgery to place, but some places will put it in in the radiology dept. I don't have a lot of love for picc lines. It still had to be placed, it can be done at the bedside. It shouldn't be in longer then a year and it has to be maintained daily. You will have to flush it and change the dressing. The biggest down fall is that it had to be covered to shower and you can't go swimming, etc. if it is going to be long term, think port. Just my thoughts. good luck and feel better!

 

[ilovevacation]

Just saw the last post. I port = port a cath

 

[grwrn]

I am a nurse practitioner and I work both hospital and office settings. I think a PICC line is an extreme option just for a quick infusion. It is opted mostly for inpatient settings when length of stay will be a week or longer and receiving multiple IV drips. It has to be changed every 5-7 days as well. A chest x-ray is even performed after being inserted to ensure proper placement.

If you are a hard stick and looking at monthly infusions indefinitely, I would look into getting a port under your skin on your chest like this.

 

[middlesista]

I am a nurse practitioner and I work both hospital and office settings. I think a PICC line is an extreme option just for a quick infusion. It is opted mostly for inpatient settings when length of stay will be a week or longer and receiving multiple IV drips. It has to be changed every 5-7 days as well. A chest x-ray is even performed after being inserted to ensure proper placement. If you are a hard stick and looking at monthly infusions indefinitely, I would look into getting a port under your skin on your chest like this.

Agree with Port-a-Cath rather than a PICC

 

[rickybobby]

Not trying to be argumentive, but a PICC does not need to be changed every 5-7 days. Dressing changes, sure, but not the line itself.

 

[disfan07]

I have a PICC line for TPN. I've had it for about 14 weeks. I will probably have it for about another 2-3 months. I ha done inserted with no sedation. Just lidocaine injections. It is a very simple procedures....at least for me it was.

Picc lines are extremely common in home health nursing situations o they are definitely not meant manly for inpatient care.

The dressing needs to be changed 24 hours after insertion and than 1x week after that or as needed (if it gets wet, dirty, etc). For me, the dressing change was painful at the beginning it its a piece of cake now. My dressing changes are done by my home health nurse.

The biggest risks of the line are blood clots and infections. I developed a blood clot 2 weeks after mine was inserted. Ive been on blood thinners ever since andi will be on them until my line comes out.

The other big thing is that you can't lift anything heavy with the arm that the picc line is in or else it can bleed or come out of place.

You only need one chest X-ray at the binning to make sure the placement is correct. The Bly reason you would need additional X-rays would be if there is a concern that it became dislodged.

But honestly, if this is a permanant treatment for you, I would say that a port a cath is a better option, not a picc line. I have a picc because it's supposed to be short term for me and actually, a picc is better than a port for tpn.

In addition, since your treatments are only monthly, you only have to flush the port after the infusion. It diesnt have to be flushed every day or every week. And you also can't see the port when it's not being accessed.

As someone with a picc line, I would not recommend it for your situation. Something more permanant would be better for you.

 

[kimblebee]

Thank you so much everybody. You really gave some great advice. I think I will talk to my neurologist about a portacath. That seems to be more of what I need. I just want the pain of monthly needles to stop.

 

[scdak]

Long time ED nurse chiming in, I think you would like a port a cath alot more too, I know I would if it were me. I deal with both devices frequently and the port is so much easier as others have said. I know that my patients tell me that accessing the implanted port is a breeze compared to multiple sticks in the arms, they don't even want to take the time to numb the area with topical medication, it literally takes all of 1-3 seconds to have the needle inserted. It takes longer to prepare the site than it does to access it. I wish more people with chronic diseases had them. And blood work can be drawn from it also in case that is something you deal with. I have found that after a while its hard to get a good blood sample for labwork but for infusions it works great. Good luck in whatever method you and your doctor decide on.

 

[jaminmd]

I am a nurse practitioner and I work both hospital and office settings. I think a PICC line is an extreme option just for a quick infusion. It is opted mostly for inpatient settings when length of stay will be a week or longer and receiving multiple IV drips. It has to be changed every 5-7 days as well. A chest x-ray is even performed after being inserted to ensure proper placement.

If you are a hard stick and looking at monthly infusions indefinitely, I would look into getting a port under your skin on your chest like this.

No, it most certainly does not have to be changed every 5-7 days. Its insertion is less invasive than a port and can be inserted by specially trained RN's (someone upthread mentioned MD's).

I think her physician can guide her to the correct form of treatment. I really wish people didn't ask medical questions online because there is entirely too much misinformation given by "experts".

 

[ToddyLu]

As a nurse, I would agree that a port would be a better option than a PICC line with your situation. Ports are better for long term use.

 

[kimblebee]

No, it most certainly does not have to be changed every 5-7 days. Its insertion is less invasive than a port and can be inserted by specially trained RN's (someone upthread mentioned MD's). I think her physician can guide her to the correct form of treatment. I really wish people didn't ask medical questions online because there is entirely too much misinformation given by "experts".

I agree with you. I'm not really asking for what to do, just different opinions. I'm so glad I did too. It definitely sounds like a port might be my best option. Of course I will discuss it with my neurologist. Now, I can research and have an actual conversation with him about it, not just listen to what he says.

 

[lsyorke]

If this infusion is going to be a long term thing(intermittent infusion over a long period of time), then a port makes more sense. If it's only for a few weeks then a picc line is the way to go. Have to chime in on the "changed every 5-7 days"...not fact.

A port will leave a scar when removed and is a surgical procedure to have it placed, a picc line won't leave a scar and is a radiology procedure, something to consider if that's a concern for you.

 

[CoffeeCup]

I had a picc line for about 3 weeks when I needed daily infusions of antibiotics. It was painless and worked well. A nurse visited me at home once or twice a week, and my husband administered the antibiotics daily. The tubes hanging down on my arm were a little annoying, but it was better than daily visits to the doctor's office.

 

[summerblue]

I had a picc line, for 3 months while pregnant, It was no big deal having it done, it was flushed daily and dressing changed once or twice a week, I have three tiny scars in the shape of a triangle (one where the tube went in, and two where it was stitched to my chest). I would not have had any pain with it had it not been for the constant vomiting so it pulled at the outside of my chest and caused pain. Putting it in they just lidocained the incision area. I had a bad dr that was not careful removing mine ( a general surgeon put it in, ob took it out) so the removal hurt worse than insertion. I should have had a port in retrospect because still had to have many more ivs after.

Whatever you choose, good luck!

 

[Feralpeg]

I also have very bad veins. When they find a usable vein, it collapses very quickly. Usually, they end up using the veins in my right hand. I cannot have anything on the left. During a recent surgery, they had to put the IV into my foot.

I had chemo this past year. They put in a port. The procedure was easy. I really don't think I'd have been able to make it through chemo without it. They have since removed the port. Now, I'm back to having problems with blood draws, etc.

OP, if you end up going the port route, just be aware that it must be flushed at least every six weeks. You do not want to develop an infection.

When I was in the hospital last year, my IV blew. The nurses could not find a usable vein. They ended up calling up a person who had a machine kind of like a ct scan. She used it to find a vein deep inside my arm and inserted the IV there. Perhaps, you could go to a hospital that has one of these machines to have your treatments.