So, in my ever evolving battle with the pancreas from hell I've now been blessed with it causing a two week hospital stay and inability to eat or drink without pain and nausea. IV meds don't touch the pain.
The next suggested step is a PICC line for bowel rest. I'm paranoid, high strung and convinced I'll die from it or it'll hurt. Since they are doing it for TPN, I'll be in the hospital for about 3-4 days to get the TPN cycle started.
I've consented, but haven't gone in. I just going out of the hospital so I wanted a weekend at home. I don't want the darn thing but it seems I don't have much of a choice. I've talked to the doctor about my initial questions but you know how it is, the more time to think the worse it gets.
Has anyone had one? Does it hurt? Can I ride? Will the put me out to place it? (I hate having an IV so...) And please tell me, how does one get over not having ANYTHING by mouth?
Ugh, I tell ya, one stupid little organ/glad can really mess with a girl's summer! Seriously, no ice cream or the beach. Please.
My daughter had so many picc lines, that they ended up having to put in a port a cath (kidney infections and Lyme). Don't let them do it at home...insist on having it done in a hospital by interventional radiology. They'll numb you up pretty well, but you do have to be really careful. She didn't ride with it though. You do want to be careful about infection.
It's like placing an iv but up higher on your arm (well above the elbow.) We always give a little lidocaine so you don't feel it so much. There's no reason to be under to have it placed, most patient chat with us during the procedure. They will likely do an xray following to make sure its in just the right place. As to riding, they will tell you what they want. My patients have all stayed in the hospital after they had one placed. You'll feel better once you've had the TPN for a bit, and start getting your energy back. It's not really something to fear; just be sure to follow the hygiene requirements to the letter. Feel better soon!
I'm just so scared. I have a hard time with IVs, and the last go round in the hospital I got a lovely case of cellulitis and some clots. It took me two days to get them to do anything about the cellulitis...it was just a mess. I know it won't be like that with Hopkins, but you know how a bad experience can make you worry.
One doc tells me not to ride period, another says go for it. So I never know when to truly believe them. Then I have one doctor who says, "no, no, no.... can't you just pet your horse?" And then another who says to ride all I want just be careful.
Is it feasible and easy to care for at home? I've got my fair share of medical experience, just more in emergency situations. Long term stuff freaks me out. I'm your girl if you break something, have a major trauma, heck I've even handled codes...but long term stuff...ugh.
And thanks Coreene, I try to think like that but I for sure need reminders!
Thanks to everyone else too. It helps tons to hear from you and your experiences!!!
PICCs are NBD. I have one every time I'm hospitalized or have surgery. Between the mast cell disorder and the collagen disorder, my veins collapse if you look at them wrong.
I'll be up front and honest with you; the first time I had a PICC done, it was NOT a good experience. The PICC team at the Brigham did it in my hospital room under ultrasound guidance. It ended up half way up my neck and man, that was NOT a feeling that I ever want to experience again. Every other time, it has been done by an Intervention Radiologist under X-ray guidance. WAY better. You get nice a numb and that's that. If you want, they'll even turn the monitor your way so you can watch! It's pretty nifty.
The danger to riding with a PICC is that if there is enough tension on the line, it can snap and a snapped line will immediately enter the heart and well...you get the picture. There is also the risk of getting dirt/debris under your dressing and ending up with a nasty infection. Very unlikely if you keep your PICC sleeve on and let someone else do the grooming/bathing.
I horse showed at HITS Saugerties two days after getting my first PICC. My trainer did the O/F classes and I did the hack. I was also coming off a month-long hospital stay, so that was more than enough for me! I haven't ridden with a PICC since that show, but it's usually because I'm too weak/sick to ride and not because I'm concerned about the danger. So long as you're not on a puller and you're taking it easy, you're likely at no more risk of something awful happening than you are at any other time you're mounted.
Chin up SFrost! You'll wonder why you were so nervous once it's over. And the TPN will make a HUGE difference for the pancreatitis; I have autoimmune pancreatitis and while I haven't had a flare in quite some time (knocks wood), I had a lot of success with TPN for that and for biliary dyskinesia/Sphincter of Oddi dysfunction as well. I would get over an attack, on average, 2 weeks faster with TPN than without it.
ETA: You'll have homecare that will come once or twice a day to run your TPN and they'll change your dressing every few days. I ran my own meds at home after a few days, but it's impossible to change the dressing by yourself and not a great idea to have a non-medical person do it as it has to remain as sterile as humanly possible. My mom (a doctor) did all of my dressing changes and the only thing homecare did was to come and remove it when I was finished with my treatments.
Good luck and feel better!!!
Nine out of ten times, you'll get it wrong...but it's that tenth time that you get it right that makes all the difference.
Ok I'll bite. I put PICCs in for a living along with managing the vascular access team. I also train staff at other facilities how to place PICC lines.
It is scary because it is unknown, but it is not that bad.
I tell all my patients the worst part is the numbing medicine and that it is a pinch and a burn. After that you will feel pressure but the practitioner should tell you what is going on so you understand.
We do outpatient PICCs at our facility and and because we use ECG technology we do not have to use x-rays or floro for confirmation of placement. We are the only nurse lead outpatient PICC team (so we do not report up through a physician) in our state.
As far as after care, we tell patients to keep the dressing clean, dry and intact. So you can't shower with it uncovered. Look at http://kevinscovers.com for waterproof but also just protective sleeves for the PICC. It will be well worth the money. Repetitive motion is what gets you into trouble with any vascular access (think pull ups and push ups) but I have a fairly liberal weight limit for PICC patients, so I usually say you can lift up to 20 lbs.
You do not want to be out in the barn mucking stalls etc. But you can ride, just keep the PICC line covered.
"If you pick up a starving dog and make him prosperous, he will not bite you. This is the principal difference between a dog and a man." Mark Twain
I have one right now! We're treating osteomyelitis following hardware placement in my broken arm. I worked in home infusion pharmacy managing home IV therapy (including TPN!) for 5 years and now have my own line for the next few weeks. They are serious business but totally manageable! If I wasn't one-armed, I'd write out a huge post to calm your fears, but alas, I am. So, if you want to talk, my cell is 919-323-9992 (for you or any other COTHer with PICC worries!) and call anytime between 7am and 10pm EST. You'll be fine!
Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.
I had one at home for 8 weeks. Nurse came the first couple of weeks but after that my mother and daughter were able to handle the IV's twice daily with no problem. I don't remember any pain with it going in or coming out. Good luck! Hoe you feel better soon.
Picc lines are much better the your typical IV. You'll do fine - used to be an oncology nurse and lots of picc lines placed. Only a few were difficult to place. Patients never said they hurt. Once there in there should be no discomfort. No pain coming out.
I had one and rode with it. It never really bothered me but I was also obsessive about preventing infection. I'm going to be honest, I had it placed under conscious sedation. I'm not a wuss about pain but I do get very anxious and there is just no reason for that when there is medicine available to stop it. Whenever I had any kind of procedure done I always insisted on conscious/twilight sedation. Just makes life easier for me and also the doctors. If you are really nervous about it, you can also ask the doc to prescribe Xanax for the morning before. I hate how doctors insist on making anxious patients suffer through the anxiety when they have the ability to help!
I had one for about a month to give i.v. antibiotics. Came out of surgery with it already in. Having it was no big deal. I wasn't riding then or able to go to the barn then...but not because of the picc line.
I was afraid to have it removed...conscious and in the doctor's office. I kept telling him to let me know when he was going to do it. He said okay. After a long time...seemed like it anyway...I asked when are you going to pull it? He said it was already done. I never felt a thing.
I was more nervous about having Mr. Ez hook me up to the i.v. push pump with the antibi's in it than anything else. He can be such a scatter brain sometimes...I watched every move he made! lol It all worked out and here I am!
I used to get picc lines all the time, and I am a HUGE weenie, if that makes you feel any better.
I always ask for xanax before because being nervous is actually worse than actually having it done. Once its in, life is so easy. I never missed anything except for swimming, they have things you can put on your arm to swim but my arms are very skinny so I have trouble keeping anything on them. I even went on vacation with one to Disney World, and my sister had one at WIHS one year.
My tips: buy lots of plastic wrap but not the kind that shrinks.
See if you can get it up as high as possible so you can cover it with your t-shirt.
For the abx get the little "iv balls" much easier to use than having to push it or having a pump but not all abx come that way so you have to ask.
You can PM me if you have any more questions! I got a port last year so have not had one since then, but I did a lot before.
I do have a video of getting one removed- my mom was sick so my auntie Carol came to pick me up and that was her reaction in the background because she never had seen that before. My sister used to take her own out when she was done because she was not wimpy like me- and if you do that, don't leave it where your dog can get it, because our dog ate it.