Picc Line

Before the procedure the nurse will sit down with you and have a chat with you, you can bring someone with you for this bit, she should explain everything that is going to happen and you to sign some paperwork to give her consent to proceed with the procedure and show you what the picc line looks like. She may give you some tips on exercises to do with your arm after you get home, if she doesn’t I will explain them here for you.

Once she has told you what is going to happen and you have signed the forms, if you have brought someone with you, then they will now have to leave the room and come back in an hour or two. The nurse will first scan your arm to find the best vein to use, it is usually the largest vein. Once she has found the vein she would like to use, she will then prepare all the equipment that she needs and will put on her gloves and apron and hat. It will look like you are in a surgical room with all the PPE she has to wear, but do not let that worry you. Once she is ready she will then give you the local anaesthetic while that is taking place she will prepare the instruments that she needs. Then she will make a small cut in your arm and vein, at any point you feel anything, then let your nurse know straight away and she will top up the anaesthetic. She will then insert the thing blue line, which is apart of your picc line, it will go in your vein, which goes up your arm around your shoulder, then down and will sit next to your heart.

When she is ready for the line to go round your shoulder she will tell you to look at her and down, so the line doesn’t follow another vein and end up going somewhere else. Then she will insert the next part of the picc line, which is the clip which has a small thin metal bit attached to it, as this will stop your pick line falling out. She will then clean the area and put a round padding around the picc line to make it comfortable for you, she will then put a clear latex dressing that has a gel in the middle, then wrap a bandage around your arm to make it more comfortable for you, you can remove the bandage if it does annoy you. I left mine on until the day of chemo. My picc line was inserted on the 20th January and my first chemo was on the 23rd some patients can have their picc line inserted on the day of chemo it all depends on how busy they are. With your picc line you do have to make some changes to the way you do things, heavy lifting is not allowed as this will damage the vein and picc line and you will end up back at the chemo unit to have it removed and a new one put in. Light duties is defiantly needed, yes it will be a little frustrating for you to have to rely on someone else to do more for you but it isn’t forever. You will also have to adapt a new way of getting dressed and undressed, depend on which arm you have the picc line in, always put your coat, shirt, t-shirt on, left arm first (this is the arm I had my picc line in) if I didn’t do that I couldn’t get dressed properly as I didn’t have the flexibility, I use to have. So I would keep telling myself left arm first, occasionally I forget and end up trying to do my right arm first but quickly realised it’s the wrong arm, so had to take the clothing off and start again with the correct arm first. In the beginning you won’t have much movement in your arm because of the swelling, the swelling will go down after a few weeks and then you will be able to do a little bit more, but still be very careful not to do too much. It was advised to me on the day I had my picc line inserted to do some little exercises, if you have a microwave teddy bear/ heat pad or something similar, put this under your armpit that has the picc line and squeeze a stress ball, as at this stage you aren’t moving the arm as much, so squeezing the ball with the heated bear or whatever you have, will help with the blood flow in that arm, if you don’t do this then your hand will go cold and tingly and you risk a blood clot. It is also advised to drink plenty off water, 3 ½ pints, this will defiantly help you and the picc line, it will also help when you have your blood test before each chemo cycle, as it will help the blood flow freely, if you don’t do this then you risk a blood clot, you can drink tea and coffee but I found that too much of these caused me to have a blood clot, and made me dehydrated, so I cut down on my tea intake. So I drunk mainly water which also helped the nurses when taking my blood and they really appreciated it. You also need to keep your dressing dry at all times, if you don’t then you risk getting an infection in your open wound, which will mean going to A&E to get it treated and to go on anti biotics, this could also delay you having your chemo until the infection has gone. As time goes on you will have more movement in your arm and you will do it without thinking about it. Listen to your arm when it knows something isn’t right, if you have done to much, your arm will be very heavy, tired and achy/ hurt. This is the time to stop and rest, otherwise you will cause problems for yourself and you will be uncomfortable. Your arm may get a allergic reaction to the latex as it thinks it is a foreign body and is trying to get rid of it, this is a common side effect from latex, I had a slight allergic reaction, I had a rash where the dressing was and a bit of itching, but not on my wound, on the side of the arm. So the nurses put me on a different dressing and my arm was happy with it and it was more comfortable as well and had more movement with my arm. When having a shower with a picc line, you need to get a shower cover to put over it to stop it from getting wet, you quickly learn to have a fast shower as the warmth of the shower cover won’t do your dressing any good as it could cause a infection from the heat. Baths aren’t recommended as you will have to keep your arm out of the bath the whole time, as you can’t guarantee the shower cover will work as well when submerged in water, it is also advised that swimming isn’t to be done, again you can’t guarantee the cover will protect you as well. The little things we take for granted, like opening a packet of biscuits can be difficult at times, with a picc line, as you don’t have the same strength you use to have, it can take a few attempts but it can be done, if not then ask someone to help. Cutting up your dinner can also be a challenge at times, I had to ask for someone to cut my dinner as I just didn’t have the strength to cut it. Even just licking your fingers when you have chocolate on them, I had to get up and wash my hands instead as I couldn’t reach my mouth with that arm anymore. Eating food off a fork was a challenge, so I learnt to eat with the other hand, it was odd at first but eventually I got use to it. Keeping the arm warm, is also vital, as if I got too cold, my arm would hurt and be uncomfortable. If I got to hot, I would be in pain and get uncomfortable, so I had to balance my temperature well. It did become hard at times but managed it. Putting on a seat belt and taking it off, you learn to do that differently as your arm isn’t as flexible as it use to be. So if your picc line is on your left arm, then you put that arm through the seat belt (if you are a passenger) then the right hand puts the buckle in. To take the seat belt off, the right hand releases it from the buckle and stretches the seatbelt out so you can remove your left arm, then your right arm puts the seatbelt back where it belongs. Yes it sounds like a normal thing to do, but how many times does your left arm normally do all the work just to put on and take off a seat belt. Getting up off a chair, without putting to much pressure and weight on your picc line arm, is a challenge but you do quickly adapt. Not everyone will have this issue but a few people I have seen have had the same problems. It also depends on how high or low the picc line has been inserted, also depends where your dressing is sitting, if it is on the bend of your elbow, then this will restrict your movement, also if the picc line has been taped down in the wrong position, like the bend in your arm, this will too restrict your movement and can also hit a nerve and stop the circulation, which isn’t fun. Your dressing will be changed weekly, if it is done more than this, then there is a chance an infection will get in, which will delay you having treatment, mine was done by the district nurses, having the dressing changed correctly is also vital, I ended up telling the nurses how to remove the dressing, wet the dressing first then pull upwards as it causes less pain, the gel on the dressing has to cover the wound and not most of the orange clip, as if this isn’t put on correctly, again an infection could happen. The removal of the picc line doesn’t hurt, but some people did find it hurt them. The nurse will pull out the blue line first, she will ask you to look the opposite way to allow the line to move through the vein, she may ask you to cough a few times which will help the picc line move if it gets stuck. Then she will start on the clip, and she may ask you to take a deep breath in and hold, then she will quickly pull the clip and metal out of your arm, for me it felt like a plaster being ripped off me. She then cleaned the wound up and put a dressing on it, which I will take off in two days and if it needs another dressing put on it, then I will put one on, if it doesn’t then I will let the air get to it to allow it to heal. I had my picc line in for 6 months and got it removed to give my arm a rest and have a bit of normality while I am waiting for my surgery date to come round. I am glad I had the picc line put it, yes they come with a lot of looking after but it beats having a cannular put in every chemo session and having needs put into your vein at every blood test. It does help your veins and you aren’t constantly having bruises on the backs of your hands and don’t have problems with trying to find a vein or problems with the needle going into your vein. If I had the option to have a picc line or not again, I’d defiantly have a picc line.