Thursday 5 January 2012

What is that bump on her arm? The PICC Line

If you have seen me since the end of October, you may have noticed a bandage on my upper left arm or maybe you saw a bump under my sleeve.  What's up with that?  It is a PICC line, or a peripherally inserted central catheter.  Essentially, it is an intravenous access to my superior vena cava.  What it looks like is an IV tube sticking out of my arm, with a bandage behind it.  I like to think it makes me look a little like Seven of Nine, but maybe not.

By the time I first saw the medical oncologist back in October, my arms were black and blue from all the blood tests I'd had.  The technicians were having a really hard time getting at my veins.  Sometimes two, three or four attempts were needed before they could get the blood they needed.  Meanwhile, blood was pooling under my skin and the bruises were lasting up to a month.  That didn't bode well for chemotherapy.

But there are options for chemo, since they expect our veins to get a rough workout.  Sometimes a Port-a-Cath is used.  In that case, a device is implanted below the skin near the collarbone and injections are made directly through or into it.  The Port-a-Cath has the advantage of being totally sealed, so bathing and even swimming are no problem.  Unfortunately, I develop keloid scars, which could easily be triggered either by the implanting of the devise or by the repeated injections into it.  I didn't want to take that chance, so chose to go with the PICC line. 

The PICC line involves a single injection in hospital, followed by a chest X-ray to ensure the line is in the proper place.  There was no pain at all involved in the installation of the PICC line and I don't feel it all (a very, very few people do feel it).

PICC line care is fairly straightforward.  I need to keep the dressing dry, so I have bought a bunch of plastic sleeves at the hospital to wear during showers.  The dressing also needs to be changed weekly.  A home-care nurse comes every Friday to change it.

No more injections, no more bruises.  The nurses use my PICC line for everything now.  The chemotherapy IV is connected to the PICC.  My blood tests, required a day or two before every chemo session, are also taken through the PICC line.  My pain pump, which was originally installed in another part of my arm subcutaneously, is now connected to the PICC line, which I am told works more effectively.  And when I was in the hospital in November, they used the PICC line for my IV fluids, antibiotics, blood transfusion, and other medication.

One time that I was at the Cancer Centre for blood tests, I was given a fabric PICC line cover that volunteers had provided.  It was made of a subtly patterned white material.  It dresses up the PICC line a bit compared to the hospital's usual elastic bandage.  Geoff and I were thinking, however, that it would be easy enough to make up a bunch of fabric PICC line covers in a variety of attractive colours and patterns.  I even bought some yarn with the intention of crocheting a black cover.  Black goes with everything, of course.

Apparently, the PICC line can be left in place for as long as a year.  If that saves me the poking and prodding and bruises of the average blood test, I'm happy to have it!

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