What is a PICC line? What is it’s function? How does it work? Is it scary? What are it’s benefits? Is it painful?
These are all common questions anybody will have as they begin their journey with a PICC line. They are all questions I’ve had in the very recent past, but now I have my PICC line and I can tell you: it really isn’t all that bad.
Let’s start here: What is a PICC line? PICC stands for Peripherally Inserted Central Catheter. It is a thin, flexible tube that will be inserted into a large vein in your arm (or chest). The tube will be threaded through the vein until it rests just above the heart. It’s function is to give medicine, nutrients, fluids or blood over a long period of time-generally several weeks, or more. Due to the fact that the tube will reside in your body just above the heart, it offers a quicker response time for medications, nutrients, etc. to get into your system-which is a great thing when treating cancer, infections or any other various diseases that would benefit from quick action.
The reality of this situation, if you’re one of the lucky chosen ones, is that you will have a tube in your body. A tube just hanging out in your body. And it’s weird. Of course the technical science of it is much more complicated:
“A PICC is inserted in a peripheral vein in the arm, such as the cephalic vein, basilic vein or brachial vein, and then advanced proximally toward the heart through increasingly larger veins, until the tip rests in the distal superior vena cava or cavoatrial junction.“ From Wikipedia. Now say that 10 times fast.
Now I know, the idea of having someone stick a tube in your body seems terrifying-and it is-but again, it really isn’t all that bad. Inevitably you will still freak out a bit before it happens, that’s just human nature-you’re aloud to freak out. But chances are you will have a really great technician inserting it for you, and they will go over everything step-by-step to ease your mind and make you feel much more comfortable about the whole process.
Here’s a tip: honestly, the scariest, most painful and uncomfortable part of the insertion procedure is surprisingly not the part where the tube goes in-it’s the Novocaine shot beforehand. Chances are you will need 2 Novocaine shots (I had 3). And yes, in case you’re wondering, it is the same shot that you get in your gums when you go to the Dentist and need work done. And it is just a as painful, and you won’t want it to happen just as much as you don’t want it to happen when you’re at the Dentist. But as always, you will get through it.
The rest of the procedure is easy as pie (or cake, or any other sweet you prefer). You’re numb. There will be uncomfortable pressure at times, but it all passes quickly. On the whole it will take about a half hour. And if you’re not freaked out by medical stuff, you’ll get to watch it all happen on the Ultrasound machine-though I’ll be honest, I had no idea what was what on the screen, it all looked like grey blobs to me.
Once the PICC line is in, you don’t feel it. There is, of course, an adjustment period. Obviously your body becomes aware of the fact that there is a foreign object now just hanging out in your chest-a slight anxiety attack in response to these feelings is not unreasonable. It will pass, though, and your body will move on and continue about it’s normal routines. Your arm will likely be sore for a few days, and the insertion site will bleed. But all of that is normal! As long as you’re not bleeding through your sterile bandage, everything will be totally fine. Once the soreness abates, you should be able to do all of the normal things you’ve always been able to do with your arm. Though slight, continued soreness is common.
Another tip here: to prepare for your PICC line, you will want to preemptively buy a sleeve to go over your PICC line to keep it all held together and nice looking. Without one you will be very uncomfortable, and the extension will dangle about and it will freak you out and cause you not to sleep well-I know this, because I lived it. Trust me on this one.
Next you will learn how to do your infusions (if you are, in fact, doing them yourself) and this will also be scary. But you will also feel a bit cool. All of a sudden you’ve become special and interesting because you have a tube in you arm, so bask in that for a few day-because it wears off quickly.
Ideally you will want to have someone else with you when you learn how to do your infusions in case you find you need help doing them on your own. My protocol is a S.A.S.H. protocol. What that means is that I flush the line with Saline, then I hook up my Antibiotics (for me it takes about 45 minutes to infuse the antibiotics), then I flush with Saline again and then, finally, I infuse the Heparin. Heparin is an anticoagulant that will prevent the formation of blood clots-yay! There are no needles involved in this process, instead you attach and infuse directly into a port connected to your PICC line. This process is also not as painful at all (if it is, call your Doc immediately), it is merely time consuming. It is important that you follow your instructions carefully, for there many things that could go wrong and it is of the utmost importance that you prevent infection as best you can.
The point of a PICC line is that you don’t have to go to a hospital, or clinic for your infusions. So with that stream of thought, you will probably also have a nurse come to your house once a week to check on you. They will also clean your insertion site and apply a new, clean bandage. If it is in your protocol, they will also take blood to ensure that everything is going according to plan.
Caring for your PICC line is obvious and straight forward. Always wash your hands before handling your extension. Always have a clean surface during infusions. If you have a sleeve, that will pretty much take care of your PICC line for you: preventing germs, tugging or pulling of the line, etc. Showering with it is fine, but it cannot get wet. If you’re like me, you over compensate by wrapping it in saran wrap, taping it all over, showering awkwardly with one hand as fast as you can while your arm sticks out clear of the shower stream. I’m positive there is an easier, less stressful and anxiety provoking way, but that is just not how I do things, apparently.
On that same note, the signs and symptoms of complications with your PICC line will also be obvious and straightforward. If you find resistance when infusing-call your Doc. Same goes for unusual pains, rashes, bleeding, oozing, leaking or swelling. If you have a fever or trouble breathing with your line, or you puke or pass out-call your Doc! Basically, anything unusual or anything that makes you nervous-call your Doc.
All in all it will be stressful and scary at times, but you will get through it and in the end you will find that it wasn’t all that bad. And hopefully it will have been a positive, helpful step in your treatment.
I apologize for the delay in this post, my own PICC line antibiotics have finally started to affect me and it is really not fun. So instead of saying ‘next week’ – cause let’s face it, I’m not very good at the steady writing of posts – I’m going to say ‘next time’. Next time I will be writing about PTLDS (Post-Treatment Lyme Disease Syndrome)-something that is very prevalent and affects many.
For more information and pictures about my personal experience with a PICC line, you can look here on my personal blog.
Where I got my information:
WebMD, “Central Venous Catheters-Topic Overview”, http://www.webmd.com/pain-management/tc/central-venous-catheters-topic-overview
Author Unknown, “Peripherally Inserted Central Catheter”, https://en.wikipedia.org/wiki/Peripherally_inserted_central_catheter
My brain: i.e. what my Doctor has told me, and my own personal experience.