Pic line questions

[jshet]

Hi everyone. We are currently deciding between a port or a pic line for my son. He will be doing IV infusion therapy every 3 mos. lasting 2 days for probably the next 3 years.
he has a bleeding disorder so a pic line may be a better way to go for him. Was hoping to hear some experiences with these lines. He did have one before, but it was removed after 3 weeks. This one will be left in for up to a year before having it changed.
I am wondering how hard it will be for me to care for this. The biggest one is will he be able to swim in a swimming pool? Or is that impossible? What about going to the beach? We have never taken him to the ocean and were hoping to make that happen for him this summer since he has been asking to do this.
He has not been a big swimmer this far. He has autism and for the last 2 months, he has been asking to swim everyday, so I am thinking this is going to be something he will want to do in the summer.
any experiences appreciated, Jshet

 

[Gorf]

Hi Jshet,
I have CF and have done pic lines for years. My veins are worn out from them and just no luck getting one in either arm middle of last year. So I now have a Port about a hands width above my right nipple. I will admit when I was first talked to about getting it, I was like no way. Now after getting it I wish I had gotten it sooner. For swimming, I don't see that happening with a pic line. The port I have only has to be flushed once a month if not in use and swimming is allowed, there is nothing sticking out when not in use. It lies just underneath the skin(access point).

 

[jshet]

Thank you Gorf. I think the docs are leaning towards the pic because of his risk for bleeding. I am thinking we would prefer the port. Couple extra questions. How long can a pic line stay in? Could it last a year? When it has to be replaced does that mean he would have to undergo the entire procedure again? Also, I have seen online wraps to keep the pic dry to allow easier bathing/showering and swimming. Have you ever heard of or tried one of these? Thank you, jshrt

 

[MichaelL]

I've been undergoing IV med treatments for the last three years using a PICC line. In terms of maintenance, the PICC needs to be flushed once a day. This really isn't hard -- you just use a saline syringe. Even though they say PICC lines last a year, this has not been my experience. I am using them continuously and I find that they generally become blocked after four months. They can swap the PICC over a wire so a new insertion is not required. However, it still has to be done. My home-care nurse has a patient whose PICC line has lasted over a year, so it obviously varies by individual.

I would say swimming in a pool or the ocean would be difficult with a PICC line. I use a Dry Pro PICC line protector (http://drycorp.com/content/picc-line-protector-information/index.html). They say it can be used to swim, but I've had problems with leaking in the bathtub. It keeps my arm very dry for showering, though. I do find it saves a lot of time and frustration compared to taping up my arm in plastic. However, the sleeves do wear out and I replace them every 4 to 6 months.

I have avoided getting a port because I would lose the convenience of my PICC line protector and have to go back to tape and plastic again. I'm also worried because my arm got really irritated after about two years so I had to have the PICC line moved to the other arm. This wouldn't have been possible with a port.

Other than the risk of bleeding, I would think a port would be better for your son since he will only be getting intermittent treatments. Maybe your centre doesn't favour it, but getting a PICC line put in every three months when he needs treatment may be a better option.

 

[jshet]

Thank you MichaelL. Can you please explain what is all involved when it has to be replaced? How difficult is it? How long does it take? I was told it would take 1-2 hours to place it initially. Would he need to be sedated to replace it the way he would be when it is placed? He does have autism, so he can only stay still for a short time. Sorry for all the questions. Thanks again, jshet

 

[MichaelL]

The initial placement for me usually takes about 30 to 40 minutes. I've seen people on here that say ten minutes, although I can't imagine how that's possible. It can take longer if they run into difficulty with the person's veins. I've heard of people taking several hours, but I think this is unusual. The estimate they gave you is probably a decent one.

They inject your arm with a numbing agent so you can't feel much although you are awake the entire time. They use an ultrasound machine to find a vein in your arm and then use an x-ray to confirm placement in the chest. I never watch what they're doing, but it seems they poke your arm, line up the vein and insert the line from there. The area is usually sore once the numbing agent wears off. I find the discomfort can last up to 24 hours.

I've had them swap my PICC line many times. I think they used the numbing agent once, but usually they don't. This is quicker -- I think like 25 or 30 minutes. They somehow put a wire into the existing PICC, pull the old one and then insert the new one over the wire. I find it much less stressful and am not as sore afterwards.