PICC Lines 101: What, Why, How…Ow?

I’ve been meaning to do a write up about my PICC line for the last week, but time got away from me a bit as I also started chemotherapy. So, apologies about the delay as this is one of the topics I’ve received the most questions about!

What is a PICC Line?

Let’s get the technical bit out of the way first. ‘PICC’ stands for ‘peripherally inserted central catheters’, and it is a long, thin, flexible tube called a catheter used to give someone chemotherapy treatment (and for other medicines too). It’s threaded into a vein until the tip is in a large vein just above the heart, then the other end is sealed with a special cap which can be attached to a drip or syringe containing for chemotherapy/other treatments.

chemo-picc-line-101
Image from www.ihadcancer.com

How is it inserted?

It’s really not a big procedure. After you are given a local anaesthetic, a specialist nurse or doctor places a PICC line into a large vein in your arm and guides it up into the main vein near your heart. They then use an x-ray to make sure everything is where it should be. Here’s a picture of my PICC line right after insertion:

img_6578
My PICC line is the second tube you can see – the first (with the pendant) is my favourite necklace making a guest appearance!

EDIT: My lovely friend Lucy, who has been through all of this and is a veteran now, pointed out that “…a few things vary depending on the Trust. Not every trust uses x-ray guided to insert the line, mine didn’t – they used an ECG and saline solution at a particular dilution to look for the correct reading to say it was in the correct place (don’t ask me how?!).

Another thing is that they don’t always offer which arm you’d like it in. The policy at my Trust is to have it inserted into the dominant arm because this arm is more mobile and less likely to clot in the line, but again it really varies from hospital to hospital!

Does getting it inserted hurt?

Short answer: No. The most painful part of the procedure was having the local anaesthetic (which stung a bit). All I felt after that was some pressure/pulling. The days afterwards involved some bruising and twinging, but a week on and I already forget that it’s there.

Longer answer: I was completely terrified about getting my PICC line inserted – I’m someone with needle phobia, and the thought of this procedure made me want to run away and ignore the whole cancer thing entirely. But of course I couldn’t do that, so off the the hospital I went – armed once again with a Diazepam buffer (please do contact your GP about this if you’ve got similar phobias).

I needn’t have panicked – the procedure took about 20 minutes and, although quite ‘medical’ feeling (in that I had to lie on my back for the whole thing in a very clinical x-ray room), it was one of the least intrusive appointments I’ve had recently. There was a lovely nurse who chatted with me the whole way through, and did a good job of keeping me distracted from what was going on in my left arm.

To be honest, getting a catheter was worse than this in my experience. Plus I got a cool picture of my x-ray at the end of it! Gnarly.

Why get a PICC Line?

The main goal of a PICC line is to spare your poor veins from the endless barrage of needles (blood draws, injections, infusions etc) that you will be having throughout treatment, which can damage them or even collapse them. I’ve also heard that having some types of chemotherapy via a cannula can sting/burn, and a PICC line helps avoid this.

Risks of a PICC Line?

There are some risks associated with a PICC line, of course. Some of these are:

  • Infection (look out for redness, swelling, hardness and heat around the area)
  • Blood clots (Macmillan says contact your hospital doctor or nurse if you notice any swelling, redness or tenderness in the arm, chest area, or up into the neck, or if your hand becomes swollen (on the same side as the PICC line)
  • It may come out (make sure it is always taped or covered with a dressing)

You can read more about these risks on the Macmillan website here. I wouldn’t let it put you off getting a PICC line though – I’ve only had mine a week and already is has been a godsend.

Looking after a PICC Line

You’ll be told how to care for your PICC line when they put it in, as well as what to watch out for. It’s mostly common sense, really, such as using a waterproof cover when you’re showering, not taking part in activities like swimming, and having the dressing changed every week (I have a district nurse who comes to my house to do this!).

There’s loads of good info regarding this on the Macmillan website, so do take a moment to give it a read through.

Other questions I had before getting my PICC line inserted (feel free to send me more)

Can I choose which arm I have it in? I was asked which arm I’d prefer, and as I’m right handed I opted for my left arm. I’d presume that’s the case usually, but don’t feel too scared to ask if you can choose if no one mentions it to you.

Can I feel it inside my arm? This was my main concern, particularly because I could feel the cannula when I had one in for my PET-CT scan, and it was miserable. Thankfully the answer is ‘no’, I am not aware of it being there at all.

Can I sleep on it? I didn’t sleep on the side with it in for the first few days after getting it done because it was a bit sore. It has been a week now, and I sleep whichever bloody way I want to with no problems.

Is it an in or out patient procedure? It’s an out patient procedure which takes about 20 – 30 minutes, then you’re sent on your way.

4 thoughts on “PICC Lines 101: What, Why, How…Ow?

Add yours

  1. Fab article! I don’t know if you want to add a little edit somewhere maybe because a few things vary depending on the Trust. Not every trust use xray guided to insert the line, mine didnt – they used an ecg and saline solution at a particular dilution to look for the correct reading to say it was in the correct place (don’t as me how?!)

    Another thing is that they don’t always offer which arm you’d like it in. The policy at my Trust is to have it inserted into the dominant arm because this arm is more mobile and less likely to clot in the line, but again it really varies from hospital to hospital!

    But like I said great article! 😘

    Like

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