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» LymeNet Flash » Questions and Discussion » Medical Questions » port, Hickman, or PICC? please tell experiences!

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Author Topic: port, Hickman, or PICC? please tell experiences!
treeinatree
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I need more information to be prepared when talking to the surgeon for consult. It sounds as though the final decision will be mine, but he will say what he thinks is best. I have searched and read old posts here, watched videos and read on the internet.

For infusing twice a day for at least a few months, and keeping line long after that whether it is used once, twice a day, or some other unknown, what has worked for you?

Doc suggests Hickman.

A nurse friend says PICC over Hickman, because it is easier to protect from water and such because it is on a limb rather than on the torso.

Some people post that they like ports, but if you are having to stay accessed all the time, why use a port? Isn't the accessed port harder to cover and easier to accidentally pull out than a Hickman would be?

I need to keep working if at all possible. And I have a sn child who needs physical help so I need my arms. Even if I take child only to wading pools over the hot summer here, I still need to be able to get splashed while helping him.

Also, I have a large chest. Will I go nuts trying to keep the Hickman in its pouch and not hitting everything, looking odd under my shirt, etc?

I am also adhesive sensitive, so I will try to start right off the bat with special dressings. If there is a huge cost difference for chest vs. arm that would be good to know too!

tree

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treeinatree
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P.S. The decision for IV being appropriate is already made because of the long infection time and my many neurological symptoms/test results.
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poppy
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One consideration is how long you will need to do IV. Hickman and other types of chest ports will last longer than a PICC.

Ports more expensive to install, and a bigger deal procedure-wise.

I think chest devices are easier to take care of, change dressing, but maybe you will have home health care doing this. Better check your insurance booklet to see how many nurse visits they will pay for. I wouldn't call and ask them, lyme on the blacklist with insurers.

It would be good to get nurse instruction in dressing changes and infusing so you could do this yourself, keep the cost down.

Many insurers will only pay for one month of IV. Best not to run up a big bill thru an infusion company and then have the insurer not pay, leaving you with it. So best to start out looking at ways to keep the cost down, in case you end up with self pay.

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treeinatree
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I don't know, but I'm guessing a long time. I know that a PICC would need to be changed.

I would do as much as possible myself, but there is a mandatory weekly home health visit. And yes there are people who can help instruct.

I'm really looking for the what-it-felt-like, what it was like on a daily basis from people.

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faithful777
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It is not easy to pull out a port line and you are only accessed so many days a week. When the huber needle comes out, you are free to shower, swim or go into a sauna.

I chose a port so I could be free on the days I do not infuse. I also have dogs and horses. I can go outside and do anything while the line is accessed. The bandage keeps it protected.

I don't even use a nurse anymore as I have learned to access myself. My Bard slim power port has been in over a year.

Also, my insurance paid for my IV costs for a year. It depends on the insurance company and the state you live in.

I researched this just like you are before I did anything. Most of the people I spoke to who had done a picc line wished they had done a port. If you have to have a picc pulled twice, you have paid for a port and less can go wrong with a port.

My husband went on IV three months ago and he got a port too. So much easier to take care of.

There is very little recovery from the surgery process. You are just sore for a few days. It cost me out of pocket $658 for my port and my husband has his done after we hit all our deductibles and coinsurance so he paid nothing for his port to go in.

For long term IV, which is what you should assume I think a port is best and easier to take care of. There is no physical restriction with a port in what you can do, and some people complain of the line pulling when they do certain things with a picc line.

I don't even know the line is in all week once it is put in.

Do lots of research to make sure you know what you can live with.

--------------------
Faithful

Just sharing my experience, I am not a doctor.

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treeinatree
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<<I chose a port so I could be free on the days I do not infuse. I also have dogs and horses. I can go outside and do anything while the line is accessed. The bandage keeps it protected. >>

That's what I was wondering. So if you are accessed for a whole week, between needle changes, the bandage really keeps the needle secure? If I am infusing twice a day that is like 14 bandage changes over that needle - is that too many for skin integrity? How do you keep from pulling out the needle when you pull off the bandage?

I have animals too. My dog is kind and sensitive, but sometimes paws with his giant paw when I least expect it. Sounds like the port would be more forgiving if I ever didn't block the paw in time, because it would mean a needle change rather than a potential line adjustment.

Thanks!!

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Dogsandcats
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I had a port for about a year. I learned to pull the needle out when I was not medicating. I could do the meds M-F and then pull it out for the weekend. The nurse would come on Monday and put the new stuff in.

I had big covers that stuck to my skin and protected it while I showered. It wasn't the best, but it worked.

I learned how to do all my meds myself and although not fun, better than driving to an infusion center.

I didn't want something on my arm so i elected the port. It did require a quick surgery to put it in and a quick to take it out.

I don't remember the dog bumping it - you could hug someone and it didn't hurt...

it really is a personal decision...or whatever your LLMD suggests.

PM me if you need more info.

--------------------
God will prepare everything for our perfect happiness in heaven, and if it takes my dog being there, I believe he'll be there.

Billy Graham

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faithful777
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quote:
Originally posted by treeinatree:
<<I chose a port so I could be free on the days I do not infuse. I also have dogs and horses. I can go outside and do anything while the line is accessed. The bandage keeps it protected. >>

That's what I was wondering. So if you are accessed for a whole week, between needle changes, the bandage really keeps the needle secure? If I am infusing twice a day that is like 14 bandage changes over that needle - is that too many for skin integrity? How do you keep from pulling out the needle when you pull off the bandage?

I have animals too. My dog is kind and sensitive, but sometimes paws with his giant paw when I least expect it. Sounds like the port would be more forgiving if I ever didn't block the paw in time, because it would mean a needle change rather than a potential line adjustment.

Thanks!!

With a port, you only change the bandage when you first access for the week. I infuse twice a day for 4 days a week. So I put the bandage on on the day I access and take everything off on the last time I access.

So I infuse Monday morning through Thursday evening. Thursday evening I peel the bandage off slowly keeping one finger on the huber needle so it stays in place until I am ready to pull it. You hold the port with one hand and pull the needle with the other hand. It is easy. My husband learned to do it very fast. I can shower Thursday-Sunday night. I use press n seal to cover the whole thing when I shower and use a hand shower.

It is very easy to protect a port in your chest from your dog, but I would expect that protecting a picc in your arm would be difficult with pets or kids.

I do use sorbaview bandages because my skin is sensitive and I feel they secure the huber needle better. Pm anytime if you need any info on a port. I am so glad I went that way.

--------------------
Faithful

Just sharing my experience, I am not a doctor.

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beths
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I have a PICC-my husband does the dressing changes.

It is annoying-I cover it with a tube sock-but I think for summer I will get a pretty PICC cover-

I shower with Glad press and seal-you can also buy waterproof covers which claim you can swim in them.

I don't have weekly nursing visits-no need [Smile]

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faithful777
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I would be afraid to swim with any kind of cover on a picc line. That is an open line to the heart.

Can you imagine what would happen if any pool water got in there?

--------------------
Faithful

Just sharing my experience, I am not a doctor.

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poppy
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Have heard of people swimming with a PICC but would be afraid to try it myself. Those covers are either so tight they nearly cut off circulation or loose enough to get on easily, but maybe too loose?
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Life+Lyme
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PORT! PORT! PORT!

I have LOVED my port! I know so many people who have had trouble with their picc lines, but don't know many with port issues.

Why I have been glad I went with the port:
-Lower infection risk
-way more long term
-you can deaccess and feel like a normal person-- your aren't always hooked up to tubing

-it is sturdy and nothing moves around to give you discomfort. I hear a lot of people are tender with their piccs. The port is thick like cork, so that needle isn't going anywhere!

-gives you more treatment flexibility. If I have to get off of IV's from herxing or symptoms/side effects, it isn't a big deal like I have to have a line pulled. Just access my port once a month and use it when I need it again.

--------------------
You name it, I've got it.
Full-time medical anomaly.

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kgg
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I have had two PICCs and now a port. I like the port better. Yes, it is sore to begin with but so is the PICC. Splashing with your son will be easier to protect with a port, IMO.
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treeinatree
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Thank you guys! Interesting that no one wrote with Hickman experience. Sounds like the port is preferred.
Tree

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faithful777
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[QUOTE]Originally posted by Life+Lyme:
PORT! PORT! PORT!

I have LOVED my port! I know so many people who have had trouble with their picc lines, but don't know many with port issues.

Why I have been glad I went with the port:
-Lower infection risk
-way more long term
-you can deaccess and feel like a normal person-- your aren't always hooked up to tubing

-it is sturdy and nothing moves around to give you discomfort. I hear a lot of people are tender with their piccs. The port is thick like cork, so that needle isn't going anywhere!

-gives you more treatment flexibility. If I have to get off of IV's from herxing or symptoms/side effects, it isn't a big deal like I have to have a line pulled. Just access my port once a month and use it when I need it again.
[/QUOTE


Yes, Yes, Yes......Exactly!!!!

--------------------
Faithful

Just sharing my experience, I am not a doctor.

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ladycakes
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I can't really compare, as I've only had a PICC. But I kept that sucker in for 5 months, and had no issues with it. I'm a little adhesive sensitive, so my arm did get a bit sketchy looking under the bandage, but nothing too bad.

Also, I got one of those "you can swim in it!" types of covers. I was never ballsy enough to try that, but I did find that I could shower normally, and no water got into it (as opposed to doing the saran wrap + stick my arm out of the shower curtain trick).

I also worked the whole time I had a PICC line in, the first round of which I was working as a veterinary tech. So lots of arm usage.

My two cents [Smile]

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tdtid
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As others have been saying, it really is more about how long the doctor plans to treat you orally. Sometimes they don't know for sure, so it's always a tough call.

In my case, my Doctor KNEW it could be up to a year (ended up being 15 months) so he recommended the port right out of the gate. I know there are pros and cons to both and since I've only had the port, I have nothing to compare it to.

I had the Power Port which worked well for me, but even with that, the surgeon will pick the best port for your body is that is the direction you are going.

To be honest, I wouldn't have WANTED the choice. I was too brain fogged to think about little things, much less whether I wanted a port or PICC.

I have known many that start with the PICC and if you need it longer than it will last, they put another one back in. Probably easier to replace since a Port needs surgery and things can go wrong with it too.

BUT I do think that for me, I was not going to get this under control without IV, so I do hope that no matter what your decision that it will start you on a path to recovery.

--------------------
"To Dream The Impossible Dream" Man of La Mancha

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Life+Lyme
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Tdtid brings up a good point. If you go the port route, look into the power port. I wish I would have.

With a power port, they can access it if you go to the ER and use it for cat scans and stuff. I end up getting two IV's when I go to the ER....

--------------------
You name it, I've got it.
Full-time medical anomaly.

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