It’s not so bad, really. Most of the time I don’t feel anything. Sometimes if I move my arm too quickly I feel pain in my shoulder or arm, but it’s brief. My main concern is keeping track of the long tubing that connects me to the medicine pump so I don’t catch it on anything when I’m moving around.
The PICC line procedure on Friday went pretty well. My definition of “pretty well” is that I remained conscious the whole time and it wasn’t horribly painful. I did, however, nearly faint during the pre-procedure blood draw where they needed five tubes of my blood. One of the labs was a pregnancy test—my second ever—and like last time (before my laparoscopy) it was completely unnecessary; one look at my CrMS chart which would show a zero percent chance of pregnancy...but of course no one would trust that. I digress. I thought I was over my fear of needles. I guess I'm not. You'd think that after all the blood work I've had done in the last couple years that I would be used to it by now. I've been having monthly draws for P+7 labs for about the last year without a problem. The fact that I hadn’t eaten anything Friday morning as instructed was probably a factor in my lightheadedness. Fortunately I was only lightheaded briefly and didn’t pass out completely; if I had fainted, I would’ve had to have gone to the ER, and they would have cancelled the procedure. I like to think I have a pretty awesome guardian angel watching over me. :) And I appreciate the prayers from all of you.
The nurse who placed my PICC line was very nice. He said he does PICC lines all day every day, which was reassuring. When I mentioned to him that I nearly fainted during the blood draw earlier, he asked if I had eaten anything, to which I replied that I was told not to so I didn't. He got upset (at the person who gave me that direction) because the nothing-by-mouth order is not necessary at all for PICC line placements. He promised to make sure I would stay conscious for the whole procedure. :) I asked if he would use my left arm since I spend lots of time on the computer and wanted my mouse-using arm uninhibited, but he reminded me that the anatomy on the right side gives him a straight, short route to the heart; the left side can be more challenging for him because it’s not so straight or short. I was immediately convinced that the right side was the way to go. ;)
First, he did an ultrasound of my upper arm to see the vein. Then he injected anesthetic so I didn't feel anything painful during the rest of the procedure aside from a strange, uncomfortable sensation that there was something deep in my arm and shoulder. (He was guiding a catheter through my arm vein so it reached my heart…superior vena cava if you want to be exact.) The actual procedure part took five minutes. I couldn't see anything he was doing—not that I wanted to look—because he had draped my arm area with a bunch of blue fabric-like paper which created a little wall blocking my view. He did another ultrasound at the end. Then I went for a chest x-ray to make sure the tip of the catheter he had inserted was in the correct place. Finally they did a test infusion of the antibiotic for a half hour to make sure I didn't have a bad reaction to it. Meanwhile they served both DH and me breakfast. The meal looked like something you'd get at a restaurant, not typical hospital food. At that point, DH declared that he was glad that he came along. He likes to be fed. :)
Three and a half hours after arrival, I left the hospital with the two “ports” (aka lumens) taped to my upper arm and covered by a cloth band that looks like a white gym sock. I was not hooked up to any medicine at that point.
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| My arm with the two ports |
The home health nurse came later to start the antibiotic and teach me what to do. Each bag of antibiotic lasts for one day (it's infused continuously over 24 hours), and then I need to change the bag. When I attach a new bag I also need to flush one port with a syringe full of saline and the other port with heparin. The second port is there in case they need to draw any labs. The heparin keeps that port from clotting up while it's not in use. I don't really feel anything when I do the flushing part. I don't see anything except the ports; there is a bandage over my skin where they are attached. The nurse will come back sometime this week to change the dressing. I'm glad I don't have to do that. :)
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| The pump, medicine, and other supplies |
In my attempts to conceal this whole arrangement from other people’s attention, I discovered that a shirt and a cardigan together are sufficient to hide the bulge that the ports create on my upper arm. The tube running from my arm to the infusion pump is long (about 5 feet). I am able to hide it under my shirt by running it up my sleeve and having it come out by my waist. The pump and bag of antibiotics are both kept in a pouch with a shoulder strap, which looks like a large camera bag. I have dubbed it the ugly purse.
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| The ugly purse (with a 8.5"x11" piece of paper behind it) |
There is no way I can hide it under my shirt. If I took the pump and antibiotic bag out of the pouch, I could possibly hide them if I strapped them to my abdomen and wore a bulky sweatshirt, but that’s not my typical attire when I go out in public. I might try that if the pump had a belt clip on it, but it doesn’t. For Mass and for running errands, I put the pump and antibiotics in my regular purse so no one would notice anything out of the ordinary (except for about an inch of clear tubing which I tried to cover with my hand). I’m sure I looked a bit strange with my purse on my shoulder during all of Mass, but no one questioned me about it. ;)
Daily activities take a bit longer to do when you’re attached to a bag all the time. Getting dressed is challenging because essentially my arm is now 5 feet longer than usual. My arm’s range of motion isn’t quite as good as normal, but it has improved since Friday when certain movements caused shoulder pain. When the phone rings, I can’t just jump up and get it; I have to gather all my tubing together with the bag to make sure I don’t snag it on something. Bathing takes a lot longer because it was drilled into me by several nurses that I cannot get the PICC line wet for fear of infection. One nurse said I could wrap my arm in plastic wrap before showering; another said no showering at all. Since it’s just for ten days, I’m avoiding the shower and using a sponge or washcloth. I wash my hair in the sink. At night the bag sits on the stand right next to my pillow so there is plenty of slack in the tubing in case I roll around while I’m sleeping. I’ve stopped sleeping on my right side because the ports dig into my arm if I lie in that position.
So far I haven’t had any bad reactions to the medicine or to the PICC line itself, aside from occasional itchiness where the tape is.
I'm glad this is only for ten days. I’ve been thinking a lot about people who need to have PICC lines in place for months at a time. I’m not sure everyone needs to be attached to their medicine 24 hours a day like I do (they may just have brief infusion periods and then can be “free” of the tubing and bag for most of the day) but it definitely has made me more sympathetic.
Less than a week to go! I’m counting down the days…
