Plot Twist: The PICC line

WARNING: There are graphic pictures included. If you are squeamish now is your chance to look away.

What is a PICC line?

A PICC Line is  Peripherally Inserted Central Catheter. Basically it is a long thin tube inserted directly into a vein starting in the upper arm and threaded to a more central location in the chest with external access ports left exposed.

The PICC line is inserted under local anesthesia using a combination of ultrasound and fluoroscope to guide the placement.

Getting the PICC line placed did not hurt. I was awake and chatting with the doctor and nurses. Afterwards my arm was very, very sore. This lasted for about a day and has steadily been improving. It does seem to feel achy after a full day of normal use.

Why did I get a PICC line instead of a port?

This is the most common question I have been getting since most people receiving chemotherapy get a port. There are 3 reasons I have a PICC line instead of a port.

  1. The size and location of my tumor (12cm x 10cm x 6cm and directly behind my sternum) make the proper placement of a port problematic
  2. The aggressive nature of my treatment is breaking apart the tumor quickly which could lead to clots and the PICC line apparently allows for better mitigation of this at this time
  3. There is healing time after a port is placed before it can be used for treatment and my doctor does not want to wait that long to start my treatment (she told me this week that she wanted to start my chemotherapy treatment even before Christmas).

What is it like?

It is like having a large bit of hardware stuck on and in you. It really doesn’t hurt but it is a little irritating. It has to be kept dry. You have to be careful not to snag the access ports (I have 2) on anything. You should not push on it (like if sleeping on your side). And I have to have the dressing professional changed once a week (they even sign and date their work).

The upside is that instead of sticking me with needles for blood tests (something I get to do very frequently now) and hooking me up with IV infusions (also a regular occurrence) they just use the access ports.

Another advantage is that the PICC line protects my veins from the chemo drugs which are apparently quite nasty.

What are the challenges? What are some solutions (they didn’t tell you about)?

I am pretty sure that the doctors and nurses involved in caring for people who have PICC lines have never had one themselves.

I asked about how to take care of the PICC line. I was told I have to keep it dry. I ask how do I take a shower. With a fair amount of enthusiasm I am told to wrap my arm with saran wrap and the stick on press and seal is supposed to work well too. Um….really? A nurse practioner pointed me to better alternatives but didn’t have specific suggestions. A little research, a lot of reviews from PICC line wearers and I was able to order a good water proof sleeve with neoprene cuffs on each end. It works well.  Waterproof sleeve

The second challenge was protecting the PICC line and access ports during the day and night so I didn’t snag them on anything. The surgery nurse gave me a gauze tube. When I looked sad at it the nurse in recovery told me I could cut up an old tube sock for a cover. The phlebotomists and the infusion center nurses told me the same thing.

I want everyone to think about this. I am very ill and not feeling good. I am going to be like this for at least the next 6 months. I now have a significant bit of hardware attached to me full time to remind of just how sick I am and how lousy I feel. And the professionals taking care of me are recommending I cover it with an old cut up sock. How does that make you feel? Not good. Seriously…offer better options.

I did some research. There are a lot of much better options. After looking at all the options I settled on this. These are made by people who have or have had PICC lines and they are perfect. They are snug but not tight. They have special slits for the access ports to slide through so you can keep the access ports off your skin (that is more irritating than you would imagine). They are infused with silver so they are anti-microbial. And they are not ugly or cludgy. I bought 3 in different colors and patterns. Picc Line cover

I am still learning about my new hardware. I have not had my first dressing change yet. So far the shower cover is working well and the PICC Line cover is comfortable and easy to use. I will post more updates as I have them.