Discussing PICC.... What Will Surgical Consult Be Like?

[Bailey Vincent]

Hey guys! So my doc just set up a surgical consultation to evaluate/discuss a PICC line. I am on antibiotics OFTEN to combat pneumonia and infections, but typically the pill variety. Because my absorption of is often messed up (seeing GI soon for that) and I can't always keep things down (despite taking Zofran)- sometimes it takes multiple rounds of pills to kick an infection... dragging on for ages. I've had success with IV antibiotics, but have never been on a real "regimen" or anything- as tend to "take it as it comes"

Still, it's WAY more successful than my current approach, and my veins are almost all retired. I can't use any veins on my right arm, and my left occasionally has success with one last, remaining vein- but lately it's been blowing out, bruising up and no success. Long story short? We are now having the PICC chat

My gut instinct is it's a good decision- may help me get on track, combat and absorb meds, as well make my frequent blood draws a lot less miserable.

But my question is: what is your success/experience with PICC? Thoughts? At a surgical consult, what will the surgeon be looking for... criteria, thoughts?

 

[rheamc]

I had a PICC line last year for TPN for about two months. I had it put in by an interventional radiologist and it took about 5 min for the procedure and it was painless. There is some education required if you are going to be taking care of it, so be ready for that if need be. For me, it was a good decision, it gave my overworked pancreas time to rest. Good luck with your decision.

 

[running4life]

Had a PICC line last year for the first time. Was AWESOME. I loved it. Did a course of 2 weeks antibiotics, they drew blood from it. It was awesome. I have a little scar on my bicep from it, but it reminds me to do my treatments and stay as healthy as possible.

They put my PICC while I was in the hospital. Guy came in, raised the bed up, turned the lights on, and began the procedure that probably took 10 minutes. I was scared to have it done, but it was no big deal. SO much better than all the IVs and needle sticks from getting blood drawn. I had been in another hospital a few days before and they pricked me all over and I had bruises for weeks. I was very thin at the time due to sickness. The guy numbed my arm first (I had it placed in my left arm because I have a tattoo on my right one that I didn't want it getting messed up), felt some pressure and looked away, and then he X rayed to make sure it was placed properly. Not much pain at all. I had requested some Ativan at first, but of course the hospital didn't bring it so I just went ahead with it so I could start my antibiotics ASAP. It was very convenient. I actually enjoyed being able to take care of it myself. Mine was done while it was cold outside so I was able to wear long sleeve shirts to cover it, but after a while I didn't care if anyone saw it. I say GO FOR IT! I didn't have any other option. Getting out was even easier. Painless.

 

[2005CFmom]

Wow, I didn't know that people still used IVs (instead of PICC or port) for antibiotic courses. My daughter has been on IV antibiotics only twice, and both times she was admitted to the hospital and had an IV for a couple days waiting for the PICC to be placed. I thought it was pretty much standard to get a PICC for IV antibiotics. She also had hers placed by an interventional radiologist (IR). Our consult was someone from IR coming to her room and going over the procedure...not really a surgery, more like getting an IV placed. She was very anxious about it so they were able to give her versed (? I think) to make the procedure easier on her.

 

[CyrilCrodius]

I wanted to do my IV course through a normal IV catheter the last time, but for some reason my veins decided to not cooperate anymore. So I had to go with the PICC.

To answer your question 2005CFmom, I'd rather have many stings during a 14 days IV course than to further lose sensitivity in 2 fingers of my hand, which happened during a PICC placement and never fully recovered. They also easily get numb now.

 

[MichaelL]

I've been on IV meds for almost 2 1/2 years using PICC lines. For me, a PICC lasts about four months before it starts to clog. At that point, they are able to switch the PICC over a wire so I don't have to get a new insertion.Including set up and putting the dressing on, my experience is it usually takes 30 to 40 minutes for a new PICC line insertion. I've heard of people with bad veins who have gone for a couple hours or more getting a PICC placed. I don't want to scare you, but it's not quick and easy for everyone. One of the radiologists told me that CF patients have trickier veins to work with. I still get kind of stressed about it, but it's really not that bad. At my hospital, they put me on a bed and get the x-ray set up to confirm placement. They then use an ultrasound to locate a good vein and numb that part of my arm. Once I have the numbing shot, I don't feel much of anything other than a little pressure. I have them put two extensions together so I can reach my PICC and flush, disconnect, etc. myself. The bandage will need to be changed once a week by a nurse.If possible, I would recommend getting the PICC placed on your inner arm about half way between your elbow and armpit. I've had them placed close to my elbow and this causes problems with the bandage coming off. Sometimes, they don't have a lot of flexibility due to location of good veins.When you shower, you'll need to cover up your PICC line to keep it dry. I used to tape a plastic sandwich bag that I cut the bottom to make it a sleeve. However, no matter how tight I taped it, I always had leakage. In addition, my arm would get irritated by tape being placed in the same place every day. I found this PICC sleeve online that works well for me. http://www.drycorp.com/waterproofpiccprotector_info.html If you decide to go with this, make sure to check their sizing information. The sleeves generally last 4 to 5 months before they break, but I still find this much better for me than the plastic bag approach.Although blood can be drawn from the PICC, I have found that this causes my PICC line to block and stop working. This probably varies by individual and how long you have the PICC in your arm. From your post, it's not clear if they're starting you on IV meds right away or not. I would not get a PICC line unless you're about to start meds soon. When you're not using it to run meds, it has to be flushed daily to keep it functioning.I hope it all goes smoothly for you.

 

[stephen]

Bailey Vincent,

I just had a PICC "installed" last Friday. (This wasn't my first.) All of them were quick, painless, and uneventful thank G-d.

The whole procedure took about 20 minutes. About half of the time was spent in preparation - cleaning my arm, and finding the vein with ultra sound. After a slight "prick" from an injection of Lidocane to numb the area, the only thing I felt was some pressure at the insertion site. From what I've heard, this is the experience most people have.

The biggest nuisance I've had with PICC lines (aside from the time spent infusing) is the inconvenience of putting on a rubber coller to keep my arm dry while showering. As for infusing itself, I've done it while driving in the car.

Hopefully, this will be your experience too.

Note: I've had Midlines too, and much perfer a PICC.

 

[Bailey Vincent]

Thank you SO much everyone for the insight and advice! In your experience, do they ever insert the PICC the same day as the consultation, or is it normally scheduled later?

 

[erock77]

I'm surprised you haven't had one too. I just had my PICC removed yesterday! I've been getting PICCS since the early 90's, on average 1 maybe 2x per year for usually 2-3 weeks. I don't recall ever having a surgeon consult, seems odd to me. I think one of the benefits is they'll protect your veins since the catheter is really flexible (like cooked spaghetti) and release the med into the large vessels at your heart. IV's may have been the culprit of blowing your veins. I usually only have peripheral IV's when I'm admitted and need drugs before my PICC can be scheduled. I usually do it through interventional radiology as well. It doesn't take 5 minutes for me, but the most painful part is injecting the numbing drug at the site. Other parts might feel a little weird, but not necessarily painful. I recommend Against stitches, the adhesive they use works well for me. I had stitches once and recall it hurting whenever there was a slight tug on the line.
Showering should be same as with an IV. I usually cut a small plastic bag at one end just bigger than the site, then tape around. Generally raising my arm to keep the area mostly out of the water.

 

[billiewoolley]

Like you, my veins are terrible! Forever collapsing, too the point I have 17 small lines in a week, it was ridiculous. They told me a PICC line would be a better option, and I was completely up for it, and it was. It was without better than a long line (which I'd also had put in, paiiiinful, and my veins collapsed after 2 days)

If I was you, I'd defiantly have the PICC line. It's not painful and its worth it in the long run, they last long.

 

[baseballfrank]

PICC lines are no big deal. Inserting them is not painful. they give you a numbing shot and you don't feel a thing. I've had about 10 PICC lines in the last 10 years. Very easy to administer meds. No pain at all. The meds they gave you are a different story. They are probably going to be powerful antibiotics to wipe the bug out. These meds always have side effects that aren't pleasant. Good luck!

 

[Bailey Vincent]

So guess what, friends? I was totally wrong. I somehow didn't grasp the concept between PICC and port (in case anyone didn't notice, lol)- so turns out I am getting a port installed in my chest... whoops. Surgery is scheduled or 2 weeks from now. So, I'd LOVE some advice. Here are my questions:

1) I have to work all summer... think I'll be able to "crawl" back to work the following day if I don't do "too much"?

2) How many stitches did you have? How was the healing process, etc?

3) I have an engagement party only a week or 2 after the surgery... think it'll look too bad? (Yes, I'm being super vein)

xoxo everyone

 

[nhaggard07]

I have had a dozen piccs. The first one was at sixteen years old and I was literally so nervous I vomited on myself. The last picc attempt they hit a nerve in my arm and it felt like a bolt of lightening! Granted I've had rare expieriences, I will still urge you to get a port placed. The procedure takes fifteen minutes and you never need a picc again! There is a downside.. You must flush your port out once a month which requires a small needle poke, but after the first month the skin over your port will go almost completely numb. The positive is that you can access your port yourself and be able to have both hands free. When I need IV meds I just call my dr and have them shipped to my home and do it all myself. Very convenient! Look into a (power port) for yourself.

 

[nhaggard07]

I didn't notice your update so disregard last post..
I weigh 160lbs and I'm 5' 9. I'm male. My port definitely shows and i am self conscience of it. If your skinny they stick out like a sore thumb. I've heard if you have some weight on you they arnt noticeable. I'm not extremely skinny and it definitely protrudes. As for how it will feel.. Mine was very sore for the first three days or so. I definitely wouldn't be back at work the next day. By the end of the week tho it will feel fine but if you knock into it like my girlfriends head did.. OUCHHHH!!!!!