Hi folks, My son is having issues with the PICC line, which we've been using since Feb of this year for daily antibiotics.
He's had allergy to chloraprep as well as biopatch, causing rashes. Now that we are aware of this, it is going better, but I wonder if there are other alternatives (13yo).
I was wondering if the under the skin catheter might be easier for him? I am not that familiar with all the pros and cons and am hoping that you all can help out.
If you have a portacath, do you access it yourself?
thx, racer
Posted by mcaringella (Member # 24848) on :
Ok...with the port-a-cath he'll go to surgery for the placement and he'll have to access it with a huber needle. Often times the access is difficult and clots can be an issue. Read up on them and see if it seems reasonable for him. One nice thing is, I'm pretty sure he'll be able to swim and shower without the worry of it getting infected. But check on that.
Posted by scorpiogirl (Member # 31907) on :
Ok I have some experiences. I had the Picc line and found that too bothersome. So that didn't work out.
I now have a Hickman Line w/ two lumens dangling out of my chest. As you know the Port is under the skin.
Now the reasons I went w/ the Hickman are
1. I didn't want to go under for the placement. 2. I don't want to go under again for the removal. 3. I didn't want a large scar on my chest where they insert the port. 4. Repeated poking will leave an additional scaring tissue that will not fade. 5. But more importantly I did not want to be poked repeatedly.
Once accessed you can leave the line in for up to a week but then you have to wrap it up, so in that instance it's no difference than having the Hickman line. The only ONE pro that I can see with the Port is that once you de-accessed it you are free to resume all normal activities. However, if you have to get IV at least once a day then you A. will have to learn to access/de-access the port daily or B. leave it in and it will be just like a Hickman.
Now if it was for chemo where they get the meds once or twice a week and then de-accessing right away than that would make sense. But it's tricky when we need to use it everyday.
Now you must take into consideration that a 13 years old boy cares more about being able to live a normal life (swimming or playing sports) than he would about two scars. And he might not care about being poked every day either so as long as he is free from it once it's done for the day. So those are the things you will have to discuss w/ him. Having the line dangling from your chest you have to be very very careful!!
Posted by racer (Member # 30438) on :
Thanks guys - you've both brought up important points that I had not considered.
I will do more reading. I did not know about the scar tissue from the repeated poking. We would plan to leave it in usually for a week, except for unusual events (like a special day of swimming). Being able to swim once in a while would be huge for him!
Plus, I am concerned about infection in the line since we can't use chloraprep or the antimicrobial disks (plus he does have sensitive skin and dressing changes really freak him out - he always feels like the line is going to get pulled out).
One other question - with a PICC, we use stretchy covers to 'contain' the tubing. Scorpiogirl mentioned being really careful about the dangles. How do you protect the little tubing set with a port when it is accessed?
thx, racer
Posted by Dogsandcats (Member # 28544) on :
I have had my port for about 6 months. I was given happy juice while the dr put in the cathedar. Maybe with a young one they would put him under.
It didn't hurt, I felt more the pushing. I was a bit sore, swollen and tired when done.
I buy plastic coverings to shower. You are not supposed to get the port wet while the huber needle is in.
I have a nurse who comes once a week and takes out the old needle and puts in a new one. Now that I only have to infuse for four days, I pull the needle out until the nurse comes. I get to take a fun shower for a few days.
The only problems I had were....1- my port a cath did get stuck and I could infuse or push in the saline or heparin. The dr sent me to a general surgeon near my home and he sent me to radiology to make sure everything was in place -it was. They then ordered a med that is injected into the port a cath to kind of root rooter it out...then it worked fine! 2). I had a nurse who didn't know how to put in a huber needle. She poked and twisted the needle. It took a couple of weeks to not hurt. Other than the nurse, who I gave two tries AFTER she had assured me she knew how to do a huber, I have had no problems When I look at pictures of a PICC, I am so happy that I chose a port. These two problems happened over six months, so that is not too bad. Maybe if you don't have to infuse every day he could have weekends off and swim, etc! Please PM me if you have ? Blessings....
Posted by Dogsandcats (Member # 28544) on :
Ps...my port is smaller than a quarter. When I take out my needle I have a small bubble looking thing where I have been poked. When I had a two week break and I could wear a top and the skin showed, no one could really notice the bubble.
My friend who had chemo, albeit she didn't probably get poked as much as me, her scar you could barely see. This was about six months after she was done. They had left it in just in case.
Posted by scorpiogirl (Member # 31907) on :
My daughter has two scars... one from the placement of the Port and the other from repeated poking. She had hers in for 25 months. Now 8 years later the scars are still there and she is very self conscious about them. I don't know if boys are different but you might want to double check with him?
As for my Hickman I made a home made pouch to wear around my neck and I tuck the lumens in there to keep them out of the way so I don't accidentally pull on them. When I go out I pin the line to my bra, since I don't like it just dangling (feels heavy to me and I'm afraid I' might pull it out of place!).
Posted by sammy (Member # 13952) on :
If your son gets a port he will still need to have the site cleansed before it is accessed. Alternative cleansers are povidone iodine or alcohol (which I'm sure you already know).
There are also alternatives to the biopatch. The one I use is made with silver ions, it's called "Silverlon Lifesaver". You can order it from Infuserve if your home infusion company cannot get it for you. Read about it here: http://www.silverlon.com/iv_catheter_dressing.html
If your son's skin is sensitive to adhesives you could try a silicone dressing. Molnycke makes one called "Mepilex Border Lite". It is sterile, self-adherent (no traditional gooey adhesives), light weight, moisture bacteria and viral proof. They are pricy but you can wear them for 7days and they eliminate the trauma of dressing changes. I have ordered them from Allegromedical.com