Is it possible to do an IV medication without having a PICC line inserted? Especially, say, if it were just for two weeks of treatment?
I'm more scared of the PICC than anything else and would rather go and get a needle every day instead.
Anyone do this instead of PICC?
Thanks,
Posted by lymeonade2015 (Member # 45611) on :
Without PICC I mean without any sort of thing inserted into your body that stays there for longer than the actual course of injection. Thanks,
Posted by TF (Member # 14183) on :
Yes, if the doctor's office offers such a service, you can go there every day and get your IV just like if you go to the ER and get an IV and then go home.
Some lyme doctors have rooms where patients sit and get their IVs.
Typically, 2 weeks of IV antibiotics for a lyme patient is like nothing.
Is this not an antibiotic?
Posted by lymeonade2015 (Member # 45611) on :
It would be IV daptomycin. I haven't decided yet if I want to try it but might be trying that next in combination with doxy and cefoperazone as per this study: http://www.ncbi.nlm.nih.gov/pubmed/25806811
I'm still trying to learn more about daptomycin before I try it. Might do longer than two weeks depending on if I herx.
Thanks,
Posted by susank (Member # 22150) on :
You could do a Saline Lock or as formerly referred to a HepLock. Temporary IV access. Nurse inserts an angiocath that is about an inch long into a vein - top of forearm probably - and the tubing - about 14" long is on the outside. (as opposed to a Picc line where the tubing is inside the vein in your body). They can stay in max 72 hours. Then a new one is put in. You can wrap the external tubing in a mesh sock-like thingie - so the tubing does not flop around. You have to flush them with saline every 8 hours and "lock" the line with a couple cc's of Heparin. I've been doing that for months. (Thank you Greta!). If you have ever had a temporary IV for anything you probably had a saline lock but did not realize it. Think of a bag of fluids and the long tubing attached to it. Take that away and you are left with the catheter in the vein and a shorter length of tubing and - behold! a saline lock!. I think these are common in labor and delivery.
If I need to infuse something - like a push or small volume drip and don't have a saline lock in at the time - I use a butterfly needle. I learned how to do that - inserting the needle in a vein in my hand. I doubt many doctors would OK that - nor would many patients want to start an IV on themselves. I just happened to be comfortable with butterfly needles having infused meds SubQ. I just had to learn how to get that relatively small needle into a vein. Being very careful about everything - but it can be done.
Posted by lymeonade2015 (Member # 45611) on :
Hey thanks I just saw this. I'm still thinking about what I am going to do. I might only be on antibiotics for 20 days or so and then taking 10 days off and then doing again. Do you really need to flush with saline every 8 hours or would every 24 be okay? Is it possible to have like 2 inches of external tubing or why does it need to be 14 inches (and not cut off the extra?)
Thanks!
Posted by susank (Member # 22150) on :
Yes you need to flush to keep the line "open" so the blood does not clot etc. It's easy to do. You want the extra length of tubing so you can use both hands to flush - unscrew and screw on syringes/whatever. I have photos of mine. Don't know how to post here though. I could send them in an email - maybe someone could post them here? I am a computer dumb dumb. Possibly you could have shorter length of tubing if you have someone there to do the flushes for you. And absolutely no cutting of tubing. You will understand when you see it. All this must be handled with extra care - as sterile as possible. It's not like cutting a water hose and splicing it. No way. Again - with a saline lock - a nurse puts the catheter in - and it can stay in for about 72 hours. Take that one out - and have one put in the other arm - different place/whatever. So you have temporary access for as long as you want. If you are not infusing for a few days then you won't need anything in your arm. Of course one has to make sure not to get the saline lock wet - I used Picc line covers in the shower. Never any problems. And so easy to unscrew the swab cap - flush - or screw on the tubing to infuse.
Posted by lymeonade2015 (Member # 45611) on :
When you lock the line with heparin does the heparin enter the vein or just prevent clotting in the line? Also - do you know if this method has lower blood clot risk than midline or PICC?
Thanks again,
Posted by susank (Member # 22150) on :
Interesting question - Sammy could better answer. But yes - the heparin - just a few cc's - flushes the vein a bit and and I am guessing stays in the catheter and the tubing. (It is locked in the catheter area).
One flushes the lock with saline then "locks" it with heparin - to prevent clotting. This keeps the vein "open" when nothing is being infused.
In this case - clotting - is different than a blood clot. Right, Sammy?
I am fairly certain with a saline lock as IV access there is less risk of blood clots and infection.
If you PM me your email address I could send you photos of mine "in situ".
I did not want a PICC line. The saline/hep lock is a wonderful alternative.
[ 10-10-2015, 06:05 PM: Message edited by: susank ]
Posted by susank (Member # 22150) on :
Further - to get an idea - go to the Infuserve website.
There you can see the extension sets - which are the PIV's. 14" and 7".
One end of the extension set is hooked up to the catheter that has been placed in your vein. The other end is connected to a microclave connector. I like the blue ones. The syringes/infusing tubing is twisted on the other end of the connector. When not in use screw on an alcohol swap cap - the orange thingies.
This sounds more complicated than it is.
Posted by Razzle (Member # 30398) on :
The only issue with doing it this way is some abx are too hard on a small vein and require being infused into a larger vein. Make sure you fully discuss this with your doctor...
Posted by susank (Member # 22150) on :
Yes - I think top of forearm veins the best.
OP - what has your doctor offered/can do in regards to IV access?
Butterfly? Peripheral (saline lock)?
Can be done in his office? You were planning to go there two times a day to get infused?
Posted by WPinVA (Member # 33581) on :
I did what TF said - went to my dr's office for a nursing appointment - got my line put in, sat there during the IV drip and went home.
I didn't do IV long enough to warrant a PICC line and - especially with Lyme brain - being responsible for that whole thing scared me. Even though there was the hassle -of driving back and forth and the expense (ouch!), I felt much more comfortable with the nurses handling the IV stuff.
I loved doing IV...yes I know how weird that sounds but you all understand ; ). Would kind of like to do more. I felt really good during that period of time.
Posted by sammy (Member # 13952) on :
You asked about the heparin lock. You only need to use 2- 3cc of heparin to lock a peripheral line. To "lock" a line you just clamp before you get to the end of a flush syringe.
If you are worried about flushing heparin into your system, then you can simply use saline locks. Most hospitals are saline only for all flushes. Only exception is to deaccess ports.
To care for a saline lock you must be willing to flush the line every 8 hrs to maintain patency. If you do not flush regularly, your catheter will not last and continue to work for you.
Posted by sammy (Member # 13952) on :
You asked if heparin lock had lower risk of blood clots.
In my honest opinion, no.
Over the past couple years I've been reading more studies that find it is better for patients to have a midline vs multiple peripheral lines for their short term medical treatments. The Midlines had less blood clots, less infiltrations, less extravassations, less infections...
This is a different opinion than what existed maybe even 5 years ago! Research ,opinions, and practices have changed.
So what do you do with this information? Consider your risks. Discuss options with your doctor. Talk with your nurses. Get familiar with what it really would be like to have a peripheral, midline, and PICC. How these decisions would impact your daily life.
Posted by susank (Member # 22150) on :
Sammy - good info.
There is the butterfly needle option - but I think lots of nurses don't want to use them.
But, I think I have read that is how some doctors' offices do infusions. They are much easier to insert?
Personally - and I have no medical training - I would think the BF's cause less damage to veins. Even though they are steel. I think I also read that being steel/metal/whatever - less chance for infection?
I think BF's hurt less than angiocaths when being inserted.
Also I think I have read where one could use a BF for a saline lock - for a day - like in the OP's case. (getting infused twice a day but one stick).
Being very careful the whole day of course - to not dislodge the needle in the vein.
Sorry so wordy - terrible head pain here - (Sammy I think I was to stop IVIG/SCIG because of this).
Posted by susank (Member # 22150) on :
Trouble posting - sorry.
Lymeonade - confused;
You need two IV's?
To be infused two times per day? or
One in each arm?
Or two drugs?
What were you told?
Posted by sammy (Member # 13952) on :
Susan,
Look at the BD IV catheter webpage. They make an updated version of the butterfly IV peripheral catheter. BD Nexiva Closed Catheter System.
It has the standard wings like you are used to. It is handled and used in the same way but this needle retracts and the plastic cannula is to be left in the vein.
Unlike a blood draw steel needle, this BD Nexiva can safely stay in place for several days.
Something to consider.
And yes, you are right, nurses will not want to use any kind of needle or catheter unless it retracts with a safety shield.
(Also, There are other brands of catheters. BD is just a well known, easy to access brand.)
Posted by lymeonade2015 (Member # 45611) on :
Thanks for all the great info. Sorry - I meant that I would need to do two different medicines but only once per day.
I'm thinking now that just getting a new butterfly needle setup everyday instead of having something stay inside my arm would be best. I'm only looking to do 2-3 weeks on medicine and then pulse so my arm could have time to heal if thats long enough? I didn't realize but it looks like they can put needles in my hand to so we could alternate? I'm just trying to find a doctor willing to do this every day now - I need to check with my LLMD because he normally uses the hospital for IV but said they wouldn't do new needle every day. Thanks again,
Posted by sammy (Member # 13952) on :
Home Health Infusion Companies will send a RN out to your house to do this for you every day. Often cheaper than hospitals.
Posted by droid1226 (Member # 34930) on :
I think a PICC is so much easier than you think. There's no question it would be more convenient for what you're considering doing. I had the same line in for 2 yrs, which is definitely not recommended & forgot it was in 99% of the time.
Also, putting it in & taking it out was a 5 minute procedure for both. I did the everyday thing with daily injections. It was way too much work. Obviously, do whatever you are comfortable with. As long as you're proactive in flushing & cleanliness, it's all good.
Someone mentioned daptomycin...That seems to be the latest, most effective IV antibiotic according to studies but who knows.
Posted by lymeonade2015 (Member # 45611) on :
Have you seen less incidence of clots with heplock VS Picc? In other words - how quickly can a clot form?
Thanks,
Posted by susank (Member # 22150) on :
Sammy - thanks for that info. Nice BF! Will comment more on it another time.
Lyme2015: wanted to quickly post two links that might interest you:
http://thetickthatbitme.com/tag/iv-therapy (Scroll way down). This gal went to doctor's office daily to get infused via BF needle. But again - some med. professionals don't want to use BF's. I think that is mainly because of their fear of needle sticks (to themselves). Sammy correct me on this if I am wrong.
I am replying because I have done BF infusions on myself and have had heplocks. (The heparin is supposed to help prevent clots anyway, right?). (And Heplocks flushed more frequently than PICC's?- would that matter?) . I guess I also don't understand the difference between blood clots that scare everyone - and blood clotting.
When I first started getting heplocks we "locked" with saline only. One time I went to flush and it would not flush. Perhaps blood clotted but was not a blood clot??? Anyway, I removed the catheter myself (the beauty of a heplock) - and the nurse came the next day and put in a new one - from then on locking with Heparin.
There are pro's and con's BF's vs Heplocks.
Note I did not get scars from either. Nor infections.
I think I read that the one drug you are considering - Dapto??? - can be given as a 2 minute push. I would think that one a candidate for daily BF's.
Doxy IV? I think I have read that it is caustic to veins - so not given through PIV's - only central lines?