posted
Hi Everyone, I have had my picc line in arm for about a year now. Weekly dressing changes are managed by the local oncology center.
They have advised that standard of care protocol (perhaps their own organization?) states the same line can't be in for more than a year. They say a new line must be installed, if one is to be maintained at all. They say it is based on manufacturer recommendations or something like that.
At any rate it has to come out or they won't maintain it. Too sick to maintain it myself and no one to help me.
I have 2 questions of this great resource group:
1. How long do y'all know/think the same picc line can safely remain intact?
2. Can y'all please help me to better understand what to expect with the removal of the picc line regarding the procedure itself and post removal care etc?
3. When the line is later reinstalled (about 3-5 months from now I think) can it be put back into the same line again?
4. The nurses at the oncology center suggested next install perhaps should be a central line port in the chest. They said in their training they are taught that those are made for longer term treatment (many years) with fewer risks (?)
However, my LLMD (a year ago) said he felt central lines were higher risk not safer. His reasoning was that central lines are nearer to the heart. That gives the body less rally reaction time between the point of bacteria entry to respond and neutralize invaders.
I should have posted this days ago but was not strong enough to post. Still not, but the line is scheduled to come out tomorrow!
Didn't realize until today how stressful this is for me. Tonight it is worse. I am really upset/scared. Never thought it would affect me like this.
My treatment is not done so it feels psychologically that I am "pulling the plug" on myself tomorrow even though I know I can get the line later reinstalled after we get back into our house and life is more settled.
My husband has emotional problems and simply can't cope with all the stress of the house, my illness, etc at the same time.
He is my primary (only) caregiver. He is extremely overwhelmed so I have no choice with this. If he goes under emotionally and becomes nonfunctional there is no one at all to help us.
I am praying the removal of the line will ease some of the pressure off until the house is done. He is not capable of administering the treatments while under this level of stress. It has risen to the level of him being on auto-pilot not conscious of his mistakes. Knowing that, stresses me out even more than having the lined removed. I can't afford him making mistakes with administering my treatment.
I have more intense mixed emotions ...more than I thought I would.
My friend, who has lyme and lives out of town, is driving here tomorrow to try and help make it a celebratory day to displace the fear and bad emotions/fears about having the line pulled. I think that will emotionally help me, but she can't answer the picc line questions, so I need your help please.
I really appreciate any help with my questions. Thank you.
Posts: 495 | From SF Bay area, CA | Registered: Dec 2007
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posted
A year is a very VERY long time for a picc to be in. I think you maxed out the time for your picc!
As far as removing it, it's a very simple procedure that can be done in a doc's office or at home by a nurse. All they do is slowly pull it out and place a sterile dressing (or even a bandaid!) on the site.
There is really no aftercare involved. But obviously if you see any pus oozing out or the site feels warm or is red/inflamed, a call to the doc is in order.
You are not pulling the plug on your treatment at all!!! But I understand how psychologically you could feel this way.
If/when you decide to get another picc it can be placed into the same vein, but some docs/interventional radiologists might be more comfortable placing the picc in the other arm.
I have found that docs are less likely to prescribe a central line as opposed to a picc. And some don't even like the idea of a picc in the first place--they would rather have you stuck every day or have a heplock inserted that has to be changed every 3 or 4 days.
If the nurses at your oncology center believe that a port would be best for you, definitely discuss the pros and cons with your doc. Your doc a year ago thought that central lines were more risky. What is his opinion now?
I am sorry to hear that your hubby has issues. I hope that he is soon in a better place and able to help you more.
Glad that your friend will be with you tomorrow.
-------------------- You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, 'I lived through this horror. I can take the next thing that comes along.'
---Eleanor Roosevelt Posts: 748 | From somewhere | Registered: May 2010
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posted
sometimes your body needs a break from therapy. a chance to regroup....I've done it, I"m sure most have.
A chest port and picc are both central lines as the tip of the catheter ends in the heart. yes, scary thought but this is what makes it stable enough to remain for up to a year.
a chest port or mediport is implanted in the chest above breast, then catheter is tunnelled under skin before entering vein. so, when it is not accessed with a needle it is not visible. Go shower, swim, kick up your heels etc. ask nurses to give you literature on ports. they are placed under sedation so don't be afraid of this. this is the access of choice for oncology patients. really best for long term therapy. I"ll look for a link.
or they could be talking about a hickman catheter which is tunnelled under skin on chest but catheter extends out just like the end of picc only larger (if this is the choice, insist on single lumen...you do not need more and more is bulky and a hassle) again, I'll look for a link. T
Posts: 40 | From CT | Registered: Dec 2010
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gee! that's quite a link, hope it works, I googled and picked the 'images' second one down
at first I think...these pics could be scary, then I see the happy people living, kids smiling and I hear Bob Marley singing "everyting gonna be alright"
Posts: 40 | From CT | Registered: Dec 2010
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blinkie
Frequent Contributor (1K+ posts)
Member # 14470
posted
Hi neighbor!
My first PICC got a hole and was replaced after 5 months. The procedure was easy. I didn't even notice they took it out. No after care either.
Had a new one placed in the other arm but only because they only would place it in that arm. They just don't put them in the side I had it the first time. But, they did consider it, They would have used a different vein.
I'm going to PM you owith some other questions.
Posts: 1104 | From N.California | Registered: Jan 2008
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posted
I had a hickman for a long time, afraid to say how long, and had it longer than PICC with less trouble. However, it does restrict some activities, more than other types of ports.
Had it put in originally because my veins were not good for PICC placement. Then after the hickman was pulled, due to infection because I overdid the outside work and the dressing sweated loose, a picc was placed by a radiologist.
The trouble is that none of us knows how long we will need these darn things and they all can have problems.
I will say that the Hickman dressing change, etc, I could do entirely myself. Don't know the situation with ports. The PICC I can change dressing but need someone to exchange extension every week.
Good luck. Removing your current PICC will be easier than you think.
Posts: 8430 | From Not available | Registered: Oct 2000
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posted
thanks everyone...really appreciate your help!!! I leave here in a couple of minutes to get the line pulled. I will check here later to further read your recommendations for next line placement.
TC, thanks for the link and all the help.
Blinkie, hey neighbor, will send you an email or PM later in reply to your questions. No time right now to reply. Stressed and running late.
My friend who was going with me had to bail out. Her mother had a heart attack and is in surgery today.
My stress right now is more psychological than the physical I think. Just feel like I am pulling the plug on myself for some reason. It is so hard to be this sick, bedridden 6 yrs, and stop treatment before it is time. No choice though. It is the safest option given my circumstances. Thanks for all the support. Y'all are wonderful!
Posts: 495 | From SF Bay area, CA | Registered: Dec 2007
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