This is topic Question: Process for Picc Line & Maintenance? in forum Medical Questions at LymeNet Flash.

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Posted by jam338 (Member # 14002) on :
hi everyone, hope someone can help me. My llmd is ordering a picc line. Says I will need to have it installed at nearby hospital so that Medicare will cover it.

My questions are:

1. How/where v is picc line installed?

2. Does it hurt?

3. What are the maintenance considerations?

4. Anything else you thunk I should know?

I know there is likely info in archives but too sick to search.

Bedridden & typing with one hand here so please don't just refer me to search; I can't.

Thank you ver much for any help.
Posted by docjen (Member # 7510) on :
Your doc should help you make the appointment with the hospital to have the PICC inserted, and to arrange for someone to help you care for the PICC line and do dressing changes. It is a quick and fairly painless procedure performed outpatient with local anesthesia. When you have the PICC inserted, ask them to give you very specific instructions on how to care for it. Mainly you have to keep it dry, avoid lifting anything more than 10 lb. with the PICC arm, and avoid excessive sweating. But ask the hospital to give you care instructions. Also, whoever does your dressing changes (home health agency?) will give you tips on how to care for it.

That's quick and dirty from my experience. Hope that's helpful.
Posted by jam338 (Member # 14002) on :
thanks DocJen. Doctor's office is making the arrangements and said they will provide a handout. Just trying to do my own homework in preparation. I was just wondering about the actual experiences of others. Appreciate any and all information, thanks.
Posted by kimp (Member # 19339) on :
Ours was inserted above the elbow. Home health nurse came w/in 1st 24 hours of insertion and then once / week after that.

Meds are daily, dripped in from IV pole over approx 1 hour. Have to sterile each time connect ABX to the line and keep dry.

If you take a shower, cover w/ Press 'n Seal or buy a cover.
Posted by cactus (Member # 7347) on :
1. How/where is it installed? Upper arm (often), inserted into a vein.

Procedure is done at the hospital. Often by a tech but my very best advice is for you to insist that a radiologist do the procedure and not a tech.

2. Is it painful? No - if you have it done by a radiologist and it's done well - it does not hurt.

I have had 2 picc lines and the first was installed by a tech. He assured me that some "discomfort" was normal.

My pain was excruciating though, and everyone at the hospital blew it off as "discomfort."

I lasted a week, each day calling the home health agency, the hospital, my home health nurse, everyone I could think of... all said discomfort was normal and I kept thinking the pain would pass.

Saw the LLMD a week later and he immediately pulled the line - it was causing the vein to spasm.

Second time installing a line, I insisted on a radiologist - on the advice of someone here - and had a patient advocate at the hospital help me make sure that a tech did not do the install.

The difference was astounding, right from the moment they inserted it.

No pain.

3. Maintenance - keep it dry. Don't lift heavy weights with that arm. Follow doc's instructions.

4. Anything else you should know? ...You will get used to it, it's easier than it sounds.

Hang in there, and I hope it is helpful for you...
Posted by SarBear (Member # 21196) on :
Hi!! I had a picc inserted back in April. If I was being honest with you, I wouldn't say it was painful or painless. Uncomfortable is the word I would use. It takes them longer to prep your arm (clean it, find the vein, and put on their sterile dress and all that) then it did to do the procedure. Honestly it has been real nice and most days I don't even remember it's in my arm! The only problem that I have had was with it floating outwards and I have also had a reaction with the dressing that they use to cover it. It is fairly easy to maintain, generally the dressing gets changed once a week which is super easy and painless. Then the only other thing is anytime you hook up to flush or use abx or anything make sure you have clean hands and follow the directions for cleaning the tip so that you don't get an infection. For me it sounded way scarier than it actually is and now I am glad that I have it!
Posted by jam338 (Member # 14002) on :
Thanks everyone for your help and answers!

My doctor said the arrangements being made would be with installation with assistance of ultrasound guidance, presumably through a radiologist, but not sure, so I appreciate your comments on that Cactus. I will make sure I insist on that!!

Cactus, what kind of patient advocate did you get ot help? I am not sure what to ask for or who to ask for that. I would really like that because of my cognitive problems where I won't be thinking clearly while there.

Is the advocate through a lyme support group or through hospital omsbudsman office or something different??

Thanks again for your help everyone!
Posted by kylasrain (Member # 12031) on :
I'll be the negative-fairy today...

I just got a line a few days ago. I have bruising around the site and the area is tender and sore. Its uncomfortable to sleep and I'm hyper-aware that it is there.

I'm not sure why people sound cheerful about it; it is in no way pleasant nor painless.

Nonetheless, it sure is useful!
Posted by SarBear (Member # 21196) on :
Kylasrain ~ I have had 4 since April because I have had a problem with the picc floating out. 2 of the times it was tender and sore for a few days but it did go away. After a few days you may get into the feeling like it is just sort of part of you and you aren't as aware of it.
Posted by cactus (Member # 7347) on :
Jam, every hospital should have a patient advocate available.

I lucked into mine - he was getting coffee at the same time as my mother... She told him my concerns & he immediately helped me.

With cognitive issues, it sure helped.

When you find out which hospital will be doing it, you could call ahead & ask for an advocate.

Tell them you're nervous, scared, and will only feel comfortable if a radiologist inserts it.

Otherwise, they often just have a tech do it.

I'm sure there are some good techs, but why take a chance?

For me, it was the difference between agonizing pain and some minor discomfort as I got used to it.
Posted by suel (Member # 8198) on :
I had a pic line done about 3 yrs ago. I was scared and this was normal. It did not take long. I also had a nurse who came to my home to check it weekly, she taught my daughter how to do everything , flushing the line hooking up meds and keeping it covered. The hardest part was not getting the arm wet. I am now again in the same process hopefully by next week, After 3 yrs of no abx I have been tested positive and out on disability once more I hated the process but the abx made me feel better and it was worth it. Good Luck

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