PICC Line Concerns/Questions

[TischSEB]

Hi,

We are having a PICC line inserted tomorrow for IV antibiotics. This will be done in a hospital, and then followed with at home “training” by a home healthcare specialist who will show us how to hook up the meds, change the dressings etc.., I have been reading up on what is involved and I keep seeing statements like:

“But it is not appropriate for every patient. Indications, contraindications and potential complications must be considered prior to insertion of a PICC line.”

Does anyone have any insight into this? My particular concerns are the fact that SEB has Raynaud's (circulation issue), elevated cholesterol, and (now) occasional heart irregularities. I wonder if any of these would create a complication since the PICC will be inserted in a vein and continue directly to the heart.

Of course I will be bringing up with the PICC people tomorrow, but wonder if you have any thoughts/experience on this issue – or your own PICC line stories?

Also, has anyone used medication (I think it starts with an “A” – saw it on a lyme blog but can't find it now) to protect the gall bladder while on Rocephin?

Thanks,
Tisch

[Suzanne]

They sent my daughter home with a PICC line when she first got sick, at age two.  It was very upsetting to me, but didn't seem to bother her at all, except when they changed the bandaging.

I still remember 'SASH' – saline, abx, saline, heparin.

She had it 21 days, and didn't take anything for her gall bladder and had no problems.  She was also on Rocephin.

She was sedated when they inserted it, and they collapsed part of her lung, but it recovered.  The nurse pulled it out with her awake, sitting on our couch.  Nothing to it.

I know an adult experience is going to be much less nerve-wracking!  I was so afraid she would pull it out (it just dangled out of her arm), or it would get too germy, or that I would inject her with air bubbles.  I threw out tons of heparin syringes that  had bubbles in them.  But we got through it and in hindsight, what she called 'arm medicine' wasn't as bad as it seemed at the time.  I think it would be harder on her now, but I think it will be fine for your patient and hope it does what it is supposed to!

Mom of teen daughter with Poly JIA since age 2. Current med: azithromycin 250 mg MWF.

[Maz]

[user=1536]Tisch&SEB[/user] wrote:

Also, has anyone used medication (I think it starts with an “A” – saw it on a lyme blog but can't find it now) to protect the gall bladder while on Rocephin?

Hi Tisch,

Yes, this medication is called, “Actigall,” (aka Ursodiol) and Dr B recommends it for patients on IV rocephin (aka ceftriaxone) as this antibiotic has a tendency to promote gall stones. It should help to reduce cholesterol and has some immunosuppressive properties, too, I think, as it's used in liver transplant patients. So, I wonder if it may actually provide some pain relief for Seb? Don't know…just following the dots here. 😉 

http://en.wikipedia.org/wiki/Ursodiol

Is Seb having the IVs through his LLMD? If so, have to wonder if it may actually help with the palps, too, if the Lyme is in his heart and causing the irregularities. 

My fingers and toes are crossed for him, Tisch…you're an amazing gal!

Peace, Maz 

 

[rebeccaavazian]

Hi Tisch,

I have sd and part of my protocol was to have iv clindy. Because my skin was very tight, sensitive and difficult and painful to draw blood it was an automatic picc line for me. Yes, i was very nervous and scared but for me i new it was something i needed to have in order to get my infusions. I've had my picc line for about 1 1/2 years now and i keep it very clean, get my dressing changes every week by a nurse who comes to my home. My amazing husband does my infusions every 3 weeks and flushes every night….its really easy to take care of. I wrap it up in the shower with press n seal plastic wrap works great! Of course you cant go underwater with the arm that has the picc, but thats the only hard part for me because i love the ocean and my pool. I know some get infusions without having a picc and are doing great but for me it was a must. If you have any questions ask away.

xoxoxo

rebecca

[Parisa]

Hi Tisch,

I have central line experience not PICC line but I can tell you that once you get past feeling overwhelmed by the newness of taking care of the line it becomes secondhand.  My husband took Actigall during the time he was on Rocephin.  They should x-ray after the PICC insertion to make sure it's properly placed and hopefully they'll find a good vein in his arm.

Good luck tomorrow. 

[maz.aust]

I had a PICC line in for 3 mths (to try to halt an out of control staph infection), like you it went from the vein under my upper arm into the area of the heart .. it was done without anaesthetic & apart from the initial prick from the needle I didn't feel anything .. Although I had the abx itself changed every day the actual area was stripped & changed every 2 days (infection control).  I always wore a one piece bright blue bandage which went from under the armpit to below my elbow which helped keep it clean & stable so that it wouldn't get caught on anything (& that people were aware when they looked at me that I was having some sort of medical treatment) .. I gave up showering because of the steam & for the 3 mths took baths & left the door open so the bathroom didn't steam up (my medical team said it was easy to keep it dry but steam is a problem) … as to the time when I got it out I just sat there & can honestly say I was amazed that I didn't feel a thing.

At the end of the day it was no biggie !  🙂

Good luck,
Maz – Aust 

Dec07: Diagnosed PRA, (CTD; Fibromyalgia; suspected Lyme):
Mar08: Diet to heal gut/bolster immune system (no gluten, dairy, sulphites or sugar)

Jan 2018: ABX Mon/Wed/Fri (started AP 2008)
1/2 x 150mg Roxithromycin(Biasig), 1/2 x 150mg Clarithromycin (Klacid),
1/2 x Fungillin, 1 x 250mg Cephalexin (Keflex)

All off days Probiotics

[TischSEB]

Hi

Thanks to all of you for your replies and stories 🙂

The PICC line insertion went fine.

Our only problem was 6 hours after the first dose/”push” of Rocephin, SEB experienced and extremely fast racing heartbeat. It did not respond to normal heart meds, and we just rode it out overnight- a little terrifying. I wasn't sure if this was a bad side effect of the meds or maybe the action of the antibiotic directly addressing the heart problem/infection.
We have done two more doses, both times without this incident, so I don't know what to make of it.

Suzanne – Now we know about SASH too! “Arm medicine” is cute – I think I am going to borrow that term:D

Maz, – Thanks for 'Actigall' . We still need to ask for this. Is this more for long term use (we are doing a one month run to start)? Otherwise, I wonder why our doctor didn't prescribe this.
And yes – the IV is through the LLMD. I am hoping it makes the heart problem go away. I had posted before that it seemed like it was “receding” while on the Doryx, so I would think the PICC right to the heart would be way more effective, altho we did have the “incident” I mentioned above.
Thanks for crossing your fingers and toes for us!:D

Rebecca – Thanks for this info! I should have remembered – so many people here with SD probably use PICCS. Here I am obsessing over a little Raynaud's! Also – thanks for the plastic wrap tip – going to use that one for sure.;)

Parisa – Hi:). Did your husband start right away with the Actigall or was that worked in later? You are right too – we are only 3 days in and it is starting to feel like second nature. The same thing happened with the IVIG – that is so old hat at this point. Incidentally, with the PICC line that will become a little easier since we can use it for both the Rocephin and IVIG infusions. The fewer needles the better.

Maz-Aust – Thanks for sharing this experience. How are you doing with that staph infection? ? We are also going to have to figure out the shower situation. (baths are impossible, can't get up). Hoping the plastic wrap solution that Rebecca recommended works!

Thanks again all of you for the hand holding on this!

Tisch

[Parisa]

Hi Tisch,

I'm glad to hear that the PICC insertion went well.  Sorry about the scary beginning.  My husband had a bad start with IV Rocephin and IVIG also but things later on smoothed out.  Yes, even if your husband is only doing a month of Rocephin he should still have Actigall.  You don't need gallbladder stones on top of everything else.

I believe my husband used Press and Seal to cover his central line when he showered.  We should have bought stock in the company!

[Author]

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